Nutrients doi: 10.3390/nu18152464

Authors: Zhengyang Zhang Yang Zhang Yufang Shi Xinyu Luo Zhixi Wei Peng An Yongting Luo Junjie Luo

Background/Objectives: Myocardial ischemia/reperfusion (I/R) injury remains a critical challenge in cardiovascular disease management. Although Chinese yam polysaccharides (CYPs), the primary bioactive macromolecules isolated from Dioscorea opposita Thunb, exhibit well-documented antioxidant and anti-inflammatory properties, their cardioprotective efficacy against acute I/R injury and the underlying multiscale mechanisms remain unexplored. This study investigated the protective effects of CYPs using an in vivo mouse model of myocardial I/R injury. Methods: An in vivo mouse model of myocardial I/R injury was used to evaluate the effects of 7-day prophylactic CYPs treatment (400 mg/kg). Echocardiographic and histological analyses were performed, and serum myocardial injury biomarkers, oxidative stress indicators, pro-inflammatory cytokines, mitochondrial ultrastructure, ATP bioenergetics, mitochondrial respiratory chain gene expression, and gut microbiota composition were assessed. Results: Echocardiographic and histological analyses revealed that CYPs pretreatment significantly ameliorated cardiac dysfunction, as indicated by increased LVEF from 28.98% to 57.68% and reduced myocardial infarct size by 36.73% compared with the I/R group and decreased serum myocardial injury biomarkers, including CK-MB, LDH, and LDH-1. Mechanistically, CYPs exerted robust cardioprotection by mitigating oxidative damage, with MDA levels reduced by 28.83% and SOD activity increased to 1.76-fold that of the I/R group, and suppressing the release of pro-inflammatory cytokines, including Tnf-α, Il-6, and Il-1β. Crucially, CYPs intervention preserved mitochondrial ultrastructure and ATP bioenergetics, and levels increased to 1.51-fold that of the I/R group and upregulated the expression of essential mitochondrial respiratory chain genes, including mt-Nd1, mt-Nd4l, mt-Cyb, mt-CoII, and mt-Atp6. Furthermore, 16S rRNA sequencing showed that CYPs treatment reshaped gut microbiota and elevated the relative abundance of anti-inflammatory and antioxidant beneficial genus Akkermansia. Conclusions: Collectively, these findings provide novel evidence that CYPs confer profound protection against myocardial I/R injury through a multitargeted network involving the restoration of mitochondrial homeostasis, attenuation of oxidative inflammation, and modulation of the gut microbiome, highlighting CYPs as a promising functional food-derived candidate for adjunctive therapy in ischemic heart disease.

Nutrients doi: 10.3390/nu18152463

Authors: Susan Gemma Anne Rice Rosara Bass Mariah Eisner Katelyn Krivchenia

Background/Objectives: Meconium ileus (MI) related to cystic fibrosis (CF) presents unique nutrition challenges for newborns. The aim of this study was to present a descriptive case series reviewing the management practice and clinical outcomes of infants with CF and MI at a large, quaternary care center. Methods: A retrospective analysis examined patients born with CF and MI over fifteen years at a large pediatric hospital in the Midwest. Patient demographics, prenatal imaging data, newborn screening results, stool studies, sweat chloride and details of the clinical course were obtained through the electronic medical record (EMR). Outcomes including length of stay (LOS), timing of surgery, and duration of total parenteral nutrition (TPN) needs were compared between infants with and without a surgical ostomy. Associations of MI severity with CF genotype, stool elastase, and prenatal imaging findings were evaluated. Results: A total of 30 neonates (21 female, 9 male) were included. Surgery was required in 26 infants, with 18 requiring ostomy placement. There were no significant correlations between CF genotype, stool elastase, or prenatal imaging findings with need for ostomy placement. Compared to those without ostomy placed, infants with ostomies had significantly longer median [IQR] LOS (71 [61, 105] vs. 22 [16, 32] days; difference 49, 95% CI 34–77) and duration of TPN (52 [41, 74] vs. 8 [6, 12] days; difference 43, 95% CI 25–62) (p < 0.001 for both). Conclusions: This work highlights the complex medical needs of these infants, requiring prolonged hospitalization and TPN for adequate nutrition. We share our institution’s approach to the nutritional management infants with CF and MI, with a focus on collaboration needed with the multidisciplinary team.

Nutrients doi: 10.3390/nu18152462

Authors: Jiapeng Song Ran Ning Yike Du Junkoo Yi Zhongmei He Jia Zhou Xuezhen Li Weijia Chen

Background/Objectives: Chronic insomnia commonly induces progressive memory decline, severely compromising human daily life and work capability. At present, there are no safe long-term available agents that can concurrently relieve insomnia symptoms and rescue accompanying memory dysfunction. This study aimed to optimize the preparation of deer brain peptides (DBPP) and zinc-chelated DBPP (Zn-DBPP), and explore their protective effects and molecular mechanism against insomnia-caused memory impairment, hoping to develop novel functional candidates for related neurological disorders. Methods: Single-factor experiments combined with response surface methodology were used to optimize the synthesis process of DBPP and Zn-DBPP. A para-chlorophenylalanine-induced insomnia mouse model was established. The structural characteristics, amino acid composition, and antioxidant activity of the products were verified via multiple spectroscopic and biochemical assays. Pentobarbital sodium sleep test and Morris water maze test assessed behavioral changes. Hippocampal neuronal morphology and BDNF-TrkB pathway expression were detected by histological staining, immunofluorescence and Western blotting. Results: The optimized DBPP achieved a hydrolysis rate of 43.89%, and Zn-DBPP possessed a zinc content of 143.37 mg/g. Successful zinc chelation, rich amino acid components, and strong antioxidant capacity were confirmed in Zn-DBPP. In vivo results showed that Zn-DBPP elevated brain zinc levels, improved learning and memory deficits, and restored hippocampal neuronal damage in insomniac mice. Mechanically, Zn-DBPP alleviated memory impairment by upregulating the BDNF-TrkB signaling pathway. Conclusions: The optimized Zn-DBPP exhibits excellent neuroprotective effects against insomnia-induced memory dysfunction. This work provides a reliable theoretical basis for the application of Zn-DBPP as a promising functional food or drug candidate for intervening in insomnia and cognitive decline.

Nutrients doi: 10.3390/nu18152461

Authors: Caitie J. Minger Matthew B. Cooke Regina Belski

Background/Objectives: Dance is a unique and physically demanding athletic art form that necessitates optimal nutritional intake for performance and long-term health. Nutrition knowledge (NK) is an essential factor that drives dietary behaviours and attitudes of athletes and performers, including dancers. Despite its importance, there appears to be limited research investigating the NK of dancers. This scoping review therefore aims to systematically explore the currently published literature on the NK of dancers globally, to understand the current levels of nutrition knowledge and gaps in knowledge as well as related dietary behaviours and inform future research and resource development for this population. Methods: Four electronic databases (MEDLINE, CINAHL, PubMed, and Web of Science) were searched in June 2026 for articles. Eligibility criteria included: Original research published in peer-reviewed journals between 2000–2025. Only English language studies reporting on the NK (general, sports, specific) of dancers were included. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was followed. Results: Of the 58 studies initially identified, a total of nine studies were included. All were quantitative and either cross-sectional (n = 5) or intervention (n = 4) studies. Data was collated from six countries with a total of 942 participants, and NK was directly assessed in all of the reviewed papers. The methodological quality and bias were assessed using the “Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research” tool. Study designs and tools used to assess NK were heterogenous. Overall, dancers demonstrated low-to-moderate NK, with gaps in knowledge surrounding macronutrient composition of foods, and exhibited restrictive dietary patterns and body image concerns. Reliance on non-expert information sources was prevalent. Interventions designed to improve NK and related dietary behaviours showed positive impacts. Conclusions: Dancers’ NK is low-to-moderate, with suboptimal dietary behaviours, often driven by aesthetic pressures and a reliance on informal nutrition advice. Given the success of interventions to improve NK, future research should focus on targeted nutrition education strategies, focused on identified NK gaps for optimising dancers’ health, performance, and long-term well-being.

Nutrients doi: 10.3390/nu18152460

Authors: Małgorzata Magdalena Michalczyk Mariola Gepfert Robert Roczniok Grzegorz Zydek

Background: Vitamin D is involved in musculoskeletal function, but evidence that supplementation improves athletic performance remains inconsistent, particularly in athletes with sufficient baseline vitamin D status. Methods: In this double-blind randomized controlled trial, 18 professional female soccer players were randomized during the autumn preparatory period (August–September) to receive vitamin D3 (4000 IU/day; n = 9) or placebo (n = 9) for eight weeks. Outcomes included total serum 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] concentrations, hematological variables, RAST total sprint time, 5- and 30-m sprint performance, and countermovement-jump outcomes. Results: At baseline, after summer exposure, 25% of participants had insufficient or deficient 25(OH)D concentrations (≤30 ng/mL). The remaining cohort (75%) had sufficient 25(OH)D concentrations (>30 ng/mL). After eight weeks, no statistically significant between-group differences were observed in vitamin D metabolites, hematological variables, or performance outcomes (Δ25(OH)D: SG +12.4 ± 8.2 ng/mL vs. PG +3.1 ± 6.5 ng/mL; p = 0.12). RAST total sprint time (p = 0.001) and 30-m sprint performance (p = 0.005) improved over time. Conclusions: Vitamin D3 supplementation at 4000 IU/day for eight weeks was not associated with additional improvements in muscle strength, sprint performance, or countermovement-jump outcomes compared with placebo. Because most participants had sufficient baseline 25(OH)D concentrations, larger trials in female athletes with confirmed vitamin D insufficiency or deficiency are needed to determine whether individualized supplementation or longer intervention periods provide additional physiological or performance-related benefits. The trial was retrospectively registered at ClinicalTrials.gov (NCT07641075) on 8 June 2026.

Nutrients doi: 10.3390/nu18152459

Authors: Melania Melis Silvia Deligia Lala Chaimae Naciri Iole Tomassini Barbarossa

Background/Objectives: Taste perception has emerged as a key determinant of eating behavior and metabolic regulation, but its relationship with body mass index (BMI) remains incompletely understood. We investigated the relationships among global, sweet, and lipid taste sensitivity; sweet- and lipid-taste-related polymorphisms; caloric intake; and BMI. Methods: Taste sensitivity was assessed using taste strips (overall and sweet) and detection thresholds for fatty acids (oleic, linoleic, and palmitic acids). Genotyping of polymorphism genes was conducted. Pearson correlation analyses examined bivariate associations between taste variables and BMI. Multiple regression models were performed to identify independent predictors of BMI and to evaluate the mediating role of caloric intake. Results: A strong inverse correlation was found between total and sweet taste sensitivity and BMI, particularly in super-tasters (STs) and participants with the sensitive genotype of sweet-taste-related polymorphisms. Similarly, greater sensitivity to fatty acids was associated with lower BMI, specifically in non-tasters (NTs) and participants with the insensitive genotype of CD36 polymorphisms. In multiple regression models, overall and lipid sensitivity were the most significant predictors of BMI, which were inversely associated with it. TAS1R2 and TAS1R3 also showed independent effects. Importantly, caloric intake was not retained in the final model. Conclusions: Taste sensitivity is inversely associated with BMI independently of caloric intake. These findings suggest that the gustatory system could influence body weight through mechanisms beyond energy consumption, probably involving food choice and extra-oral receptor-mediated metabolic regulation. Taste perception and related genetic factors may represent important targets for personalized nutrition and obesity prevention strategies.

Nutrients doi: 10.3390/nu18152458

Authors: Maria Oana Săsăran Monica Grama Cristina Roxana Mareș Andreea Bianca Stoica Rodica Demenciuc Brîndușa Căpîlnă Ancuța Lupu Cristina Oana Mărginean

Introduction: Hypocalcemia represents a major cause of seizures in children in the absence of fever or infections. Hypovitaminosis D, usually associated with a lack of proper prophylactic regimens, can trigger those events. This case series aims to highlight two cases of hypocalcemic seizures in infants, attributed to severe vitamin D deficiency, with the aim of raising awareness regarding the importance of vitamin D prophylaxis. A narrative review of the literature is also provided, which highlights similar reported cases. Methods: We hereby report two cases of male infants (aged 4 months and 5 months) who presented to the emergency department of a tertiary pediatric center with seizures in the absence of fever or infections. Diagnostic work-ups revealed low levels of total serum calcium and ionic calcium deficiency. The cause of the hypocalcemia turned out to be severe vitamin D deficiency in both cases, caused by complete absence of vitamin D supplements since birth and during maternal pregnancy. In both cases, combined oral calcium and vitamin D supplementation led to complete resolution of symptoms and restoration of normal calcium levels. A comprehensive review of the literature is also provided, which focuses on pediatric studies and case reports that analyzed the prevalence, particularities, and outcomes of hypocalcemic seizures related to vitamin D deficiency. Articles including subjects with congenital or endocrine disorders that could have caused hypocalcemia were ruled out. Results: After accessing the full-length form of each article and applying the inclusion and exclusion criteria, 27 articles were included, namely 14 studies and 13 case reports. Hypocalcemic seizures caused by vitamin D deficiency are more common in infants, are usually linked to maternal hypovitaminosis D, and have a higher prevalence in developing countries. Most of the case reports depicting hypocalcemic seizures were distinguished through very low vitamin D levels. Conclusions: These case series emphasize the importance of vitamin D supplementation for the prevention of hypocalcemia, which constitutes a major metabolic cause of seizures in infancy. Nevertheless, maternal vitamin D supplementation during pregnancy is the only factor that can ensure the presence of satisfactory deposits in the newborn and prevent hypovitaminosis D-related complications.

Nutrients doi: 10.3390/nu18152457

Authors: Dorota Zierkiewicz Stanisław Manulik Anna Chudiak Dorota Krówczyńska Wojciech Homola Piotr Pobrotyn Janecka Wioletta Mariola Głowacka Małgorzata Paprocka-Borowicz Mariusz Chabowski

Background/Objectives: Surgical treatment of colorectal cancer (CRC) is associated with a substantial risk of postoperative complications and delayed recovery of functional capacity, particularly in older patients and those with multiple comorbidities. Preoperative prehabilitation has emerged as a strategy aimed at optimizing patients’ physical, nutritional, and psychological status prior to surgery; however, its clinical effectiveness and feasibility of implementation remain subjects of ongoing debate. The aim of this narrative review was to provide a clinically oriented synthesis of current evidence regarding multimodal prehabilitation in patients undergoing CRC surgery, with particular emphasis on perioperative outcomes, functional recovery, nutritional optimization, and implementation-related considerations. Methods: A targeted narrative review of the peer-reviewed literature indexed in PubMed (2015–2025) was conducted to identify contemporary review-type publications, including narrative reviews, systematic reviews, scoping reviews, and meta-analyses, addressing prehabilitation in CRC surgery. The findings were synthesized narratively and interpreted with emphasis on clinical applicability and translational relevance. Results: Twenty contemporary review publications were included in the analysis. Across the included publications, the most frequently reported favorable effects were observed for multimodal prehabilitation, incorporating physical exercise, nutritional support, and a psychological component. These interventions were associated with improvements in functional capacity and, in some meta-analyses, with a reduction in postoperative complication rates and shorter length of hospital stay, particularly in high-risk patients. Prehabilitation was assessed as safe and well tolerated. Conclusions: The current body of evidence indicates that multimodal prehabilitation may constitute a beneficial adjunct, particularly in improving functional capacity, while its impact on hard postoperative outcomes remains closely dependent on intervention quality, appropriate patient selection, and seamless integration with established perioperative care pathways. Future meta-analyses should address underexplored components of prehabilitation, including preparation for stoma formation and targeted educational and psychological support related to sexual health.

Nutrients doi: 10.3390/nu18152453

Authors: Yusha Araf Theo Portlock Justin M. O’Sullivan

DNA methylation is a key epigenetic mechanism linking nutritional exposures to gene regulation and downstream phenotypes. Both undernutrition and overnutrition are associated with distinct methylation signatures, some of which persist beyond the initial exposure window and may relate to long-term metabolic, immune, and neurodevelopmental outcomes. However, the extent to which these associations reflect causal mechanisms, adaptive responses, or secondary effects remains unresolved. Here, we synthesize current evidence on how nutrition influences DNA methylation across the life course, integrating biochemical pathways, metabolic signaling, and microbiome-derived processes within a unified framework. We highlight how these diverse inputs converge on core regulatory axes, including methyl donor availability, enzyme activity, and chromatin context. We then evaluate emerging long-read sequencing, single-cell methylomics, deconvolution strategies, and multi-omic integration methodologies that are improving cellular resolution and enabling a more mechanistic interpretation of nutritional epigenetic variation. Despite these advances, major challenges remain, including tissue specificity, measurement limitations, and the difficulty of distinguishing causation from correlation in observational data. We argue that progress will depend on longitudinal and interventional study designs, improved causal inference frameworks, and integration of functional validation with high-resolution molecular profiling. Addressing these challenges will be critical for determining whether nutrition-associated methylation changes represent biomarkers, mediators, or causal drivers of disease, and for translating epigenetic insights into precision nutrition strategies.

Nutrients doi: 10.3390/nu18152456

Authors: Stefania Toselli Emanuela Gualdi-Russo Luciana Zaccagni

Background/Objectives: Body image is influenced by body weight, sociocultural norms, and weight-related behaviours. Migration has been associated with changes in body ideals, potentially through acculturation processes. This study investigated body image perception, weight status, and related behavioural and psychological factors among a group of African immigrant women living in Italy, comparing them with an Italian comparison group. Methods: This cross-sectional study included 131 women (60 African immigrants; 71 Italians). Body image perception was assessed using the Thompson and Gray silhouette scale. BMI-based weight status was derived from self-reported weight and height and compared with perceived weight status. Body dissatisfaction was calculated as the discrepancy between perceived and ideal body image. Additional measures included appearance-related anxiety (PASTAS), self-esteem, life satisfaction, physical activity, and adherence to the Mediterranean diet. Results: Immigrant women had significantly higher body weight and BMI (p < 0.001) and differed in distribution across weight status categories (p = 0.001). Although body dissatisfaction did not differ significantly between groups, immigrant women selected larger ideal body figures (p < 0.001). They also showed lower agreement between BMI-based and perceived weight-status, and higher appearance-related anxiety on the PASTAS Non-Weight subscale (p < 0.05). No significant differences were observed in self-esteem, life satisfaction, or adherence to the Mediterranean diet. Immigrant women were more likely to be sedentary (38.3% vs. 4.2%) and reported lower levels of physical activity (active: 25.0% vs. 54.9%). Conclusions: Compared with the Italian comparison group, African immigrant women in this study showed a greater prevalence of overweight and obesity, preference for larger body ideals, lower agreement between BMI-based and perceived weight status, and lower physical activity levels. Given the cross-sectional design and the characteristics of the recruited samples, these findings should be interpreted as associations rather than evidence of causal relationships. They support the need for culturally sensitive strategies to improve weight awareness and promote healthy lifestyles among African immigrant women.

Nutrients doi: 10.3390/nu18152455

Authors: Juan P. González-Rivas María Rodrigo-García Amparo Rodríguez Sánchez Álvaro Díaz Conradi María Zelmira Bosch

Background: The prevalence of pediatric obesity in Spain is among the highest in Europe. Although national surveillance reports a 4.5% decrease in excess weight, these primarily cross-sectional data may underrepresent the metabolic complexity observed in clinical settings. We aim to characterize the evolution of abnormal adiposity and to evaluate the transition probabilities between body mass index (BMI) categories in a multi-regional Spanish cohort. Methods: We analyzed Real-World Data (RWD) from 37,465 children and adolescents (ages 0–18) treated at HM Hospitales “Observatorio de la Obesidad Infantil,” between 2021 and 2026. Longitudinal BMI z-score trajectories were evaluated using continuous-time Markov chain models to determine transition probabilities between weight categories and identify developmental windows of adiposity plasticity. Results: At baseline, 21.6% of the cohort presented overweight/obesity, with a higher frequency of overweight in females than males (13.0% and 11.2%, respectively; p < 0.01) and obesity similar between sexes (~10%). Markov modeling identified a “critical window” in children aged 2–5, who demonstrated a 75% probability of reverting to a normal weight. Conversely, children aged 6–11 entered an “adiposity trap,” characterized by a 60.0% obesity persistence rate and a 23.2% risk of progressing from overweight to obesity. A sharp initial drop in z-scores was observed immediately following the baseline clinical assessment across all groups. Conclusions: Our study reveals a significant window of opportunity for abnormal adiposity improvement between the ages of two and five, which contrasts with the adiposity inertia (diminished category fluidity) observed after age five.

Nutrients doi: 10.3390/nu18152454

Authors: Anna Łupińska Sara Aszkiełowicz Arkadiusz Zygmunt Renata Stawerska

Background/Objectives: Children with autoimmune gastrointestinal diseases are at increased risk of impaired bone health due to chronic inflammation, nutritional deficiencies, growth disturbances, and treatment-related factors. While dual-energy X-ray absorptiometry (DXA) is the standard method for assessing bone mineral density (BMD), it provides limited information on bone microarchitecture. The trabecular bone score (TBS), derived from lumbar spine DXA images, has emerged as a complementary marker of bone quality. This study aimed to evaluate bone mass and TBS in children with autoimmune gastrointestinal diseases and to assess the clinical utility of TBS in comparison with children with a history of fractures and healthy controls. Methods: This study included 152 children aged 5–18 years: 45 with autoimmune gastrointestinal diseases (Crohn’s disease, ulcerative colitis, or celiac disease), 37 with a history of fractures, and 70 healthy controls. Anthropometric measurements, serum 25-hydroxyvitamin D [25(OH)D] concentrations, DXA-derived parameters, and TBS values were analyzed. Bone mineral density was assessed at the lumbar spine and total body less head (TBLH), with additional adjustment for height-for-age Z-score (HAZ). TBS values were expressed as sex- and pubertal stage-adjusted Z-scores. Results: Low bone mass (aBMDfor age Z-score ≤ −2) was observed in 30.3% of participants at TBLH and 11.1% at the lumbar spine, whereas a TBS Z-score ≤ −2 was identified in 5.2% of children. No significant differences in TBS or TBS Z-scores were found among the study groups. In multivariable analysis, fracture history was independently associated with lower absolute TBS, whereas no independent predictors of TBS Z-score were identified. Children with fractures had significantly lower HAZ-adjusted lumbar spine aBMD Z-scores than children with autoimmune gastrointestinal diseases and controls. TBS Z-scores correlated positively with age-adjusted and HAZ-adjusted aBMD values but showed no association with BMI or serum 25(OH)D concentrations. Conclusions: In this cross-sectional study, TBS did not distinguish children with autoimmune gastrointestinal diseases from those with fractures or healthy controls in the unadjusted analyses. Although TBS was associated with selected DXA-derived measures of bone mineral density and fracture history was independently associated with lower absolute TBS after multivariable adjustment, no independent predictors of TBS Z-score were identified. These findings suggest that the clinical role of TBS in the assessment of pediatric bone health remains to be established. Larger prospective studies are crucial to determine whether TBS provides clinically meaningful information complementary to conventional DXA for the assessment of skeletal health and fracture risk in children. Larger prospective studies are needed to clarify the clinical value of TBS for fracture risk assessment in pediatric autoimmune gastrointestinal diseases.

Nutrients doi: 10.3390/nu18152452

Authors: Xing Li Juan He Khalid S. Ibrahim Michal R. Baran James Reilly Christo J. F. Muller Johan Louw Hui-Rong Jiang Xinhua Shu

Background: Hepatic lipid metabolism disorder has been linked to a wide range of diseases. Aspalathin is a flavonoid enriched in rooibos tea and has shown capacity to protect against hyperlipidemia, oxidative stress and inflammation. In the current study, we investigated the functional role of aspalathin in regulating liver metabolism and gut microbiota in the context of a high-fat diet (HFD). Methods: Male mice were fed a control diet or HFD, then HFD-fed animals were treated with or without aspalathin-rich extract (ASE). Hepatic neutral lipids were detected using oil red O staining and a colorimetric assay. Expression of cholesterol metabolism-, lipogenesis- and fatty acid β-oxidation-associated genes was measured. Gut microbiota was analyzed using 16S rRNA sequencing and bioinformatic approaches. Results: HFD-fed mice had markedly higher levels of triglycerides and cholesteryl esters and downregulated expression of cholesterol metabolism-, transport- and lipogenesis-related genes in the liver. ASE administration counteracted HFD-induced effects. In addition, HFD altered the composition, diversity and metabolic pathways of the gut microbiota. The richness of beneficial bacteria, particularly the butyrate-producing bacteria, was significantly decreased. The altered metabolic pathways are involved in the metabolism of carbohydrates, lipids, amino acids and nucleotides, as well as mitochondrial function. ASE treatment reversed most of the alterations back to the characteristics of the control group. Conclusions: Our results demonstrated the potential of ASE improving liver lipid metabolism and gut microbiota in the scenario of a high-fat diet, providing insights into future studies on the mechanism of ASE regulating lipid metabolism disorder.

Nutrients doi: 10.3390/nu18152451

Authors: Gaetano Pacinella Anna Maria Ciaccio Carlo Domenico Maida Vittoriano Della Corte Giuseppe Miceli Mario Daidone Cosimo Quaranta John Sebastian Soldano Antonino Tuttolomondo

The heart is a highly energy-demanding organ that depends on metabolic flexibility to adjust substrate utilization in response to changes in nutrient availability, endocrine signals, and energetic demands. Accumulating evidence demonstrates that dietary patterns are key determinants of myocardial metabolic homeostasis, affecting substrate selection, mitochondrial function, nutrient-sensing pathways, and long-term transcriptional and epigenetic regulation. This review analyzes the molecular mechanisms through which diet regulates cardiac metabolism and explores how chronic nutritional exposures influence the myocardial energetic phenotype. The physiological regulation of cardiac substrate utilization is described, with emphasis on fatty acids, glucose, ketone bodies, and branched-chain amino acids, underscoring the importance of metabolic flexibility in sustaining cardiac efficiency. The regulation of substrate transport and oxidation is examined, including the roles of the carnitine shuttle, insulin signaling, AMPK, mTOR, PPARα–PGC-1α, SIRT3, and other nutrient-sensing networks that coordinate mitochondrial ATP production. The effects of dietary composition and meal timing, such as caloric restriction and intermittent fasting, are discussed as modulators of myocardial metabolism. The adverse effects of chronic nutrient excess are reviewed, including lipotoxicity, glucotoxicity, insulin resistance, mitochondrial dysfunction, oxidative stress, pseudo-hypoxia, fetal metabolic reprogramming, and maladaptive cardiac remodeling. Recent findings on the gut–heart axis, microbiota-derived metabolites, circadian regulation, and metabolic–epigenetic interactions are also considered. Overall, current evidence supports the view that diet is an important and potentially modifiable regulator of the cardiac metabolic phenotype. Advancing the understanding of diet–metabolism interactions may enable the development of targeted nutritional strategies to maintain metabolic flexibility, enhance cardiac bioenergetics, and prevent the progression of heart failure and other cardiometabolic diseases.

Nutrients doi: 10.3390/nu18152450

Authors: Amama Rani Sojin Kang Sojin Kim Jung-Hyun Kim Jimin Kim Muhammad Alaa Eldeen Eunbin Ko Chanju Im Moon Nyeo Park Yunju Jeong Byung-Kwan Seo Hyun Chul Jung Bonglee Kim

Background/Objectives: Physical exercise has been a cornerstone of health and vitality across all age groups; however, while its importance remains undeniable, the complications associated with exercise such as fatigue, muscle damage, inflammation, and oxidative stress are not always effectively managed through conventional strategies. This review aims to highlight the current evidence on the potential role of natural products in alleviating these exercise-induced responses and supporting exercise performance and recovery. Methods: The available preclinical and clinical literature was comprehensively reviewed to evaluate the effects of natural products on exercise performance and recovery. Evidence was categorized according to five major mechanisms: attenuation of muscle fatigue, enhancement of muscular endurance, improvement of muscular strength and neuromuscular function, modulation of inflammation and other physiological benefits. Results: Approximately 164 natural products have been investigated for their potential to improve exercise performance and recovery by targeting fatigue-related markers, improving energy metabolism, and regulating oxidative stress. Conclusions: These findings underscore the potential of natural products as promising agents as complementary strategies for addressing exercise-induced fatigue and improving recovery. Although current findings indicate biological plausibility and therapeutic potential of natural products, further clinical evidence is required before definitive performance related recommendations can be established. Future well-designed clinical trials are essential to establish efficacy, safety and translational applicability.

Nutrients doi: 10.3390/nu18152449

Authors: Furkan Göz Muhammad Jamil Adnan Kavak Sema Bayraktar Ali Can Doğru Gautam Srivastava Hossein Fotouhi

Background/Objectives: The objective evaluation of regional dietary intake remains a core challenge in personalized health management due to complex plate presentations and a lack of culturally specific dataset benchmarks. Methods: This study introduces a confidence-aware hybrid vision–language framework engineered for traditional Turkish food recognition and structured nutritional assessment. Results: We curate a balanced dataset containing 14,711 verified images spanning 40 representative Turkish culinary classes to train and evaluate seven deep learning architectures. Among the visual models, EfficientNet V2-L achieved the highest standalone performance with an accuracy of 93.47%, 0.92 macro-precision, 0.92 macro-recall, and a 0.92 F1 score. To overcome visual ambiguity and automate content analysis, a confidence-aware routing strategy escalates uncertain predictions (τ<0.70) or user-rejected classifications to the Google Gemini 2.5 Flash multimodal large language model (MLLM). Conclusions: This hybrid paradigm yields a combined classification accuracy of 95.50% while validating portion weight estimations within a mean absolute error (MAE) of 18.42 g and total energy within 36.75 kcal. Fully realized as a cross-platform Flutter mobile application, the end-to-end pipeline demonstrates localized plate detection, adaptive portion analysis, and structured nutrient tracking, providing a scalable design for consumer-facing digital nutrition platforms.

Nutrients doi: 10.3390/nu18152448

Authors: Timur Liwinski Sandra Nussbaum Lukas Imfeld Ulf Wein Undine Lang

Background/Objectives: People with severe mental illness experience high rates of malnutrition and cardiometabolic disease, and hospital food is increasingly regarded as part of clinical care rather than mere catering. Although nutrition is increasingly recognised as a therapeutic component of psychiatric care, little is known about how the professionals closest to nutritional care would design an inpatient meal concept. Methods: We conducted a cross-sectional, anonymous online survey of 26 nutrition professionals working in psychiatric settings in the German-speaking D-A-CH region (Germany, Austria, and Switzerland), who rated the goals, patient needs, dietary forms, meal characteristics, organisational aspects, and barriers relevant to an inpatient meal concept on five-point Likert scales. Free-text responses were analysed thematically. Results: Respondents prioritised eating enjoyment (mean [M] = 4.65) and psychological stability over economic goals, and rated both appetite loss and hyperphagia, together with medication-related metabolic change, as key patient needs. A Mediterranean dietary pattern was clearly the preferred model (M = 4.62), whereas low-carbohydrate options were the least endorsed form (M = 2.65). Interprofessional communication between nursing, kitchen, and dietetics was the highest-rated item overall (M = 4.75), while budget restrictions were seen as the principal barrier. Conclusions: In this small, self-selected expert sample, experts largely converged on a patient-centred, Mediterranean, flexible and choice-based meal concept delivered through strong interprofessional processes, supporting a shift from catering toward nutrition as a therapeutic component of inpatient psychiatry.

Nutrients doi: 10.3390/nu18152445

Authors: Qian Zhang Xiaotong Wu

Background: Type 2 diabetes (T2DM) is a chronic metabolic disease closely associated with insulin resistance (IR) and disturbances in glucose and lipid metabolism. Bioactive peptides derived from food are attracting increasing research attention as candidates for nutritional supplements or functional food ingredients that improve metabolic health. This study evaluated the functional food-related properties of YPWTQ (CP4), a novel peptide derived from donkey blood, and its ability to alleviate insulin resistance in HepG2 cells. Methods: CP4 was characterized based on its hemolytic activity, stability under simulated gastrointestinal digestion conditions, inhibitory activity against α-glucosidase and Pancreatic lipase, and free radical scavenging capacity (DPPH·, ABTS+·, and O2−·). Its effects on glucolipid metabolism and oxidative stress were examined in a glucosamine-induced insulin-resistant HepG2 cell model. Candidate signaling pathways associated with CP4 treatment were explored through transcriptomic and metabolomic analyses, combined with RT-qPCR technology. Results: CP4 exhibited low hemolytic activity and remained stable after 4 h of simulated gastrointestinal digestion. It inhibited α-glucosidase and Pancreatic lipase and exhibited antioxidant activity. In insulin-resistant HepG2 cells, CP4 increased glucose consumption, glycogen content, and cell survival, while reducing triglyceride accumulation, malondialdehyde levels, and reactive oxygen species (ROS) production. Mult omics analysis indicates that these phenotypic effects may be associated with coordinated changes in the PI3K-Akt, AGE-RAGE, Rap1, and Ras signaling pathways, as well as related genes and metabolites. Conclusions: These findings suggest that CP4, as a food-derived bioactive peptide candidate, warrants further investigation into its potential applications in the field of metabolic health.

Nutrients doi: 10.3390/nu18152447

Authors: Valentina Álvarez-Arraño Karen Toledo-Stuardo Marjo J. E. Campmans-Kuijpers Fabien Magne Marcela A. Hermoso

Ulcerative colitis (UC) and Crohn’s disease (CD), known as inflammatory bowel diseases (IBDs), result from a complex interaction of genetic, immunological, microbial and environmental factors. There is growing evidence suggesting that imbalances in the gut microbiota, or dysbiosis, play a causal role in IBD and are strongly influenced by aspects of the Western lifestyle. Diet is an important modulator of gut health, and whole cereals have attracted attention for their potential to positively shape gut microbiota and intestinal function. Germination further enhances the content of prebiotic substrates and bioactive compounds such as polyphenols, GABA and fiber, which may modulate inflammation, oxidative stress and immune responses. In vitro and clinical studies suggest that these compounds may reduce pro-inflammatory cytokines and improve symptoms in IBD, although robust evidence in patients is still lacking. Here, we provide an overview of whole and sprouted cereals and their effects on inflammation and gut microbiota, with particular focus on IBD. We also discuss the potential of sprouted grains as a complementary approach to diet alongside conventional therapy, highlighting their possible support to gut health to mitigate inflammation. Finally, we emphasize the need for further well-designed clinical studies to confirm their therapeutic potential and to better understand the mechanisms underlying their beneficial effects.

Nutrients doi: 10.3390/nu18152446

Authors: Gabriele Saccone Mariarosaria Motta Francesco De Seta Salvatore Mola Sara Iannantuoni Nicoletta Di Simone

Objective: To evaluate the real-world effectiveness and tolerability of Iron Hydroxide Adipate Tartrate (IHATTM) in women with iron deficiency across three common obstetric and gynecologic clinical settings: pregnancy, the postpartum period, and abnormal uterine bleeding. Methods: This prospective multicenter observational real-world study included women with iron deficiency managed in routine clinical practice across Italy. Participating gynecologists collected data using standardized case report forms. Patients received IHATTM according to routine clinical practice and were followed for approximately three months. Baseline demographic and hematologic parameters were recorded, including hemoglobin and ferritin levels. The primary outcome was the change in hemoglobin between baseline and follow-up. Secondary outcomes included changes in ferritin levels, treatment adherence, and tolerability. Results: A total of 517 women was included in the analysis. The study population included pregnant women (N = 287, 55.5%), women with abnormal uterine bleeding (N = 161, 31.1%), and women in the postpartum period (N = 69, 13.3%). Improvements in hemoglobin were observed across all clinical settings, with hemoglobin increasing from 10.35 g/dL at baseline to 11.63 g/dL at three months, corresponding to a mean increase of 1.28 g/dL. Mean ferritin levels increased from 22.50 ng/mL to 37.74 ng/mL in three months. Treatment adherence was high or moderate in 93.4% of patients. Gastrointestinal adverse events were infrequent, with constipation (9.7%) and nausea (4.8%) among the most reported. Conclusions: In this prospective real-world multicenter study, treatment with IHATTM was associated with meaningful improvements in hemoglobin and iron stores in women with iron deficiency across pregnancy, postpartum, and abnormal uterine bleeding. The treatment showed good adherence and a favorable tolerability profile in routine clinical practice.

Nutrients doi: 10.3390/nu18152444

Authors: Nada Oršolić Snježana Ramić Ivana Turk Daniela Ančić

Background/Objectives: Malignant ascites is characterized by extensive tumor dissemination within the peritoneal cavity, abnormal fluid accumulation, and progressive multiorgan dysfunction, including hepatic and renal impairment. Methods: The present study was conducted to evaluate the protective effects of resveratrol (RSV) and its nanocrystal formulation (NANO-RSV) at doses of 25 and 50 mg/kg against Ehrlich ascites tumor (EAT)-induced hepatic and renal injury by assessing proliferating cell nuclear antigen (PCNA) expression and apoptosis/necrosis rates, which are key indicators of tissue injury, repair, and regeneration. In addition, microvessel density (MVD) was evaluated in peritoneal tumor tissue, liver, and kidneys to assess angiogenesis and tissue remodeling, while macrophage polarization in the spleen was examined to determine the immunomodulatory effects of RSV and NANO-RSV. Results: Resveratrol and its nano formulations acted as potent inhibitors of EAT cells growth through downregulation of PCNA expression, leading to increased tumor cell death via apoptosis and secondary necrosis. In EAT-bearing mice, the hypoxic microenvironment was associated with increased PCNA expression, enhanced angiogenesis, and reduced apoptosis in hepatic tissue. In contrast, treatment with resveratrol and nano-resveratrol reduced PCNA expression, increased apoptotic activity, suppressed angiogenesis, and induced hepatic steatosis. Progression of steatosis, particularly in resveratrol-treated animals, was associated with impaired hepatic regenerative capacity. In the kidneys, elevated PCNA expression and increased cell death indicated active tissue injury accompanied by compensatory proliferative responses. Furthermore, increased splenic arginase-1 activity correlated with enhanced tissue damage and activation of M2 macrophage-mediated repair mechanisms. Conclusions: In conclusion, resveratrol exhibits significant antitumor activity but may induce organ toxicity, whereas its nanocrystals formulation demonstrates improved safety while maintaining efficacy. Enhanced stability, bioavailability, and sustained-release properties of nano-resveratrol contribute to reduced hepatic and renal injury compared with native resveratrol.

Nutrients doi: 10.3390/nu18152443

Authors: Elizabeth J. Marjanovic Mark D. Farrar Richard Kift Mohamed Z. Mughal Ann R. Webb Lesley E. Rhodes

Background: Sun exposure guidance advises minimisation to reduce skin cancer risk, but advice is geared for white-skinned people. Melanin reduces skin synthesis of vitamin D from solar ultraviolet radiation (UVR), and adolescence is a key life-stage for bone mass acquisition. Methods: This prospective cohort study investigated year-round vitamin D status and its determinants in 143 South Asian adolescents (12–15 y; brown skin) living in Greater Manchester, UK. Serum 25OHD, personal UVR doses, time outdoors, and photoprotective measures were assessed across four seasons, and the findings were compared with those of 131 white Caucasian adolescents studied using identical protocols. Results: Severe vitamin D deficiency (25OHD < 25 nmol/L) was prevalent in South Asians, affecting 79% of girls and 69% of boys in winter, persisting year-round in 59% of girls and 23% of boys, and accompanied by winter PTH levels > the upper reference range in 59% of boys and 45% of girls. Personal UVR doses and time outdoors were lower on summer weekend days (boys 53 min, girls 60 min) vs. schooldays (boys 105 min, girls 108 min) in South Asians (p < 0.01). The findings contrasted with those in white Caucasians, where time outdoors was similar on summer weekend days and schooldays (weekend days: boys 131 min, girls 101 min, p < 0.01 vs. South Asians). Only 26% of South Asians vs. 86% of white Caucasians took a holiday abroad during the year, and days abroad significantly contributed to vitamin D status. Both groups had low oral vitamin D intake. Conclusions: Raising vitamin D status is crucial to prevent secondary hyperparathyroidism in South Asian adolescents and skin type-related sun exposure guidance is required.

Nutrients doi: 10.3390/nu18152442

Authors: Mio Matsuoka Hiroko Shimaya Yoshihito Iwanami Shohei Iijima

Background/Objectives: The semi-solid enteral nutrition method, in which semi-solid nutrients are administered through a gastrostoma rather than liquid nutrients, is a medical technology for nutritional management developed in Japan. This nutritional method has spread rapidly, and in 2018, the Home Semi-solid Enteral Nutrition Guidance and Management fee was newly established in the payment system for medical services. However, there are few studies evaluating this nutrition method in actual clinical practice. Methods: Using the DeSC medical claims database, we investigated patient characteristics, the number of fee calculations, and the length of hospital stay for all hospitalizations and for pneumonia during and after fee calculation. Results: Home semi-solid enteral nutrition guidance and management was received at least once by 3105 patients (mean age: 79.4 years). Cerebrovascular disease, nervous system disease, dementia, and pneumonia were the most common diseases at the start of guidance and management, and the mean number of sessions received was 7.7. The mean length of stay for any hospitalization was significantly shorter during the guidance and management period than after the last guidance and management session (8.2 vs. 29.1 days). Notably, the mean length of hospital stay for pneumonia was also significantly shorter during the guidance and management period than after the last guidance and management session (3.1 vs. 10.2 days). Conclusions: This study clarified the calculation status of the Home Semi-solid Enteral Nutrition Guidance and Management fee and outcomes of patients who received this guidance and management. These findings suggest that the provision of this guidance and management may be associated with the shorter length of hospital stay. However, because residual confounding cannot be ruled out, a causal relationship cannot be established. Overall, the provision of this guidance and management may be associated with maintaining stable home care.

Nutrients doi: 10.3390/nu18152441

Authors: Amapola De Sales-Millan Paulina Reyes-Ferreira Rina María González-Cervantes Mariana Luna-Álvarez Sara Guillén-López José F. Cobo-Díaz Sandra Ramos José Félix Aguirre-Garrido José Antonio Velázquez-Aragón

Background/Objectives: Gut dysbiosis in children with autism spectrum disorder (ASD) has been associated with alterations in microbial ecology and metabolic function that may contribute to gastrointestinal dysfunction and the severity of clinical manifestations. Synbiotic and probiotic supplementation has emerged as a promising microbiome-targeted strategy for ASD; however, its effects on gut microbiome composition, functional potential, and clinical outcomes remain incompletely understood. We conducted a longitudinal study of Mexican children diagnosed with ASD to analyze changes in the composition, diversity, and functional potential of the gut microbiome during six months of multi-strain synbiotic supplementation. Methods: Stool samples were collected from 25 children with ASD at baseline and after 3 and 6 months of multi-strain synbiotic supplementation. Gut microbiome composition and diversity were analyzed by 16S rRNA gene sequencing, whereas whole metagenome sequencing (WMS) was performed in a subset of samples to evaluate the functional potential of the fecal microbiome. Gastrointestinal symptoms were assessed using the Rome IV criteria, and ASD severity was evaluated with the Childhood Autism Rating Scale (CARS). Results: Twenty-five children with ASD completed the 6 months of synbiotic supplementation. Overall, ASD severity decreased, reflected by a reduction in total CARS score, and improvements in several CARS domains. Gastrointestinal symptoms also decreased significantly. Longitudinal microbiome profiling revealed significant taxonomic and diversity changes over the supplementation period, while WMS identified changes in microbial metabolic potential, including enrichment of tryptophan biosynthesis pathways and reduced L-rhamnose degradation. Conclusions: This exploratory research provides proof-of-concept evidence supporting multi-strain synbiotic supplementation in children with ASD. Larger controlled studies are needed to confirm these findings and clarify their relevance to microbiota–gut–brain axis interactions. The observed concordance between clinical improvements and microbiome remodeling supports further investigation of microbiome-targeted interventions according to ASD severity and duration of supplementation.

Nutrients doi: 10.3390/nu18152440

Authors: Jeffrey Justin Margret Sushil K. Jain

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder marked by amyloid-β buildup, tau pathology, neuroinflammation, and declining cognition. Adiponectin, a hormone produced by adipose tissue with insulin-sensitizing, anti-inflammatory, and antioxidant effects, may link peripheral metabolic health to brain function. Studies show that adiponectin helps neurons survive, improves synaptic plasticity, maintains blood–brain barrier integrity, and reduces amyloid-β and tau damage via AdipoR1/R2 signaling. Clinical studies evaluating circulating adiponectin have yielded inconsistent findings, giving rise to the ‘adiponectin paradox’ whereby elevated adiponectin levels in older adults and patients with AD may reflect frailty, weight loss, systemic inflammation, or compensatory responses rather than direct neuroprotective effects. Studies indicate that vitamin D (VD) and L-cysteine (L-Cys), a precursor to glutathione, act synergistically to modulate oxidative stress, inflammation, and adiponectin levels. VD increases circulating adiponectin and benefits metabolism, while L-Cys boosts glutathione, restores redox balance, and promotes adiponectin secretion by affecting fat cell function. Emerging experimental evidence, together with clinical observations from metabolic disorders, suggests that VD and L-Cys may influence adiponectin-related pathways, oxidative stress, and inflammation, which are implicated in AD pathogenesis. However, direct clinical evidence demonstrating that combined VD and L-Cys supplementation modulates these pathways or alters AD progression in humans is currently lacking. This narrative review covers current knowledge of adiponectin and its links to obesity, metabolic issues, and AD, and it also explores the roles of VD and L-Cys as regulators of adiponectin signaling. Overall, the available evidence supports the proposed interaction among VD–L-Cys and adiponectin, which warrants further mechanistic investigation and well-designed clinical studies to determine its therapeutic relevance in AD.

Nutrients doi: 10.3390/nu18152439

Authors: Angeliki Kapellou Sevastiani Papailia Thanasis Fotis Dimitrios Miltiadis Vrachnos Dimitrios Papageorgiou Effie Salata Eleni Ntoumou Spiros Vittas

Background/Objectives: Type 2 diabetes (T2D) is a multifactorial disorder arising from complex interactions between genetic susceptibility and environmental exposures, including diet. This systematic review aimed to synthesize and critically evaluate evidence on gene–diet interactions in T2D-related phenotypes among adults without diagnosed T2D at baseline. Methods: The review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251175793). PubMed and Embase were systematically searched for eligible studies published up to November 2025. Observational studies and intervention trials examining interactions between dietary exposures and genetic variants, haplotypes, or genetic risk scores (GRSs) in relation to incident T2D, insulin resistance, glycemic traits, or β-cell function were included. Risk of bias was assessed using study design-specific tools. Results: A total of 61 reports representing 27 unique studies met the eligibility criteria, comprising 30 reports of randomized trials and 31 reports of non-randomized studies. Across studies, 55 Single Nucleotide Polymorphisms (SNPs) in 40 genes were examined, while 11 studies evaluated GRSs. The most frequently studied loci included TCF7L2, ADIPOQ, FTO, IRS1, GIPR and PPM1K. Reported interactions involved dietary patterns, macronutrient composition, dietary fat quality, fiber/whole-grain intake and specific foods, influencing incident T2D, insulin-related traits and glycemic outcomes. However, findings were heterogeneous, frequently inconsistent, and often lacked independent replication. Most randomized and non-randomized studies were judged at high or serious risk of bias. Conclusions: Genetic variation may contribute to interindividual differences in metabolic responses to diet, although robust and reproducible gene–diet interactions remain limited. Larger, well-powered, standardized studies across diverse populations are needed to establish clinically meaningful applications of Precision Nutrition (PN) in T2D prevention.

Nutrients doi: 10.3390/nu18152438

Authors: Tansheet Jawad Naureen Rehman Muzna Hashmi Arjumand Rizvi Zahra Ali Padhani Saleema Gulzar Hira Farooq Rasool Bux Imran Ahmed Chauhadry Jai K. Das

Background: Adolescents in low- and middle-income countries face a disproportionate burden of dietary inadequacy, yet evidence on the determinants of overall diet quality remains scarce. This study assessed the prevalence of macro- and micronutrient inadequate intake and identified factors associated with dietary adequacy among adolescents in rural Pakistan. Methods: A cross-sectional survey was conducted among adolescents using multistage cluster sampling. Dietary intake was assessed through a single 24-hour dietary recall; nutrient adequacy was determined using age-and sex-specific Dietary Reference Intake (DRI) standards, including Estimated Average Requirements (EARs), Adequate Intakes (AIs), Estimated Energy Requirements (EERs), and Acceptable Macronutrient Distribution Ranges (AMDRs), as appropriate. Overall dietary adequacy was quantified using the Mean Adequacy Ratio (MAR), calculated as the unweighted mean of nutrient adequacy ratios for fourteen nutrients, including protein, fiber, calcium, iron, zinc, thiamin, riboflavin, niacin, vitamins A, B6, C, D, E, and folate, scaled from 0 to 100. Multivariable linear regression incorporating survey weights and clustering was used to identify independent predictors of MAR using STATA. Results: A total of 1132 adolescents were included. Most of the energy was derived from carbohydrates, and a high proportion of adolescents had energy intakes below age- and sex-specific Estimated Energy Requirement (EER) values, while very high levels of inadequacies were observed for protein, fiber, calcium, vitamin D, and vitamin A. The mean MAR score was 54.04 ± 16.51, indicating overall poor dietary adequacy. In multivariable analysis, male sex (β = 3.26; 95% CI: 1.76, 4.75), belonging to the richest wealth quintile (β = 5.81; 95% CI: 1.76, 9.86), always eating between meals (β = 6.70; 95% CI: 3.93, 9.47), and use of bar soap for handwashing (β = 4.97; 95% CI: 2.00, 7.94) were significantly associated with higher dietary adequacy. Adolescents who were underweight (β = −2.40; 95% CI: −4.81, −0.11) and those with moderate physical activity levels (β = −3.96; 95% CI: −7.62, −0.29) had significantly lower dietary adequacy scores. Conclusions: Dietary inadequacy among rural adolescents in Pakistan was highly prevalent and was associated with socioeconomic, behavioral, and nutritional factors. These findings highlight the need for interventions that address food insecurity, promote equitable food distribution, and strengthen nutrition education to support adolescent health and nutrition. However, these findings should be interpreted in light of the cross-sectional design and the use of a single 24-hour dietary recall, which may not reflect habitual dietary intake.

Nutrients doi: 10.3390/nu18152437

Authors: Ethan A. Mezoff Qing Duan Nicholas J. Ollberding Elizabeth J. Reverri Rachael H. Buck Bridget Barrett-Reis Kimberly Yolton Ardythe L. Morrow

Objectives: Preterm infants confront multiple coexistent health risks and may not receive human milk (HM), which contains human milk oligosaccharides (HMOs), among other biologically active, beneficial components. 2′-Fucosyllactose (2′-FL) is the most abundant HMO in most HM. Interventional studies of formula with added HMOs have demonstrated multiple beneficial outcomes in healthy, term infants. Methods: This double-blind, randomized, placebo-controlled pilot study (NCT03306316) evaluated the effect of a 2′-FL supplement on growth, tolerance, and neurobehavior, as assessed by the Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale (NNNS), in preterm infants. Eligible neonates born between 26 0/7 and 31 6/7 weeks gestational age (GA) were enrolled from three NICUs in the United States. Preterm infants consuming mother’s own milk or donor human milk were randomized to receive a supplement of 0.135 g/mL of 2′-FL or 0.05 g/mL dextrose (placebo) twice daily until 36 weeks corrected GA, NNNS assessment, or hospital discharge, whichever came first. Results: Of 42 participating preterm infants, 23 (55%) received 2′-FL and demonstrated no significant differences in growth in weight, length, or head circumference over 5 weeks. There were also no differences in stool frequency, adverse (AEs) or serious adverse events (SAEs), or neurobehavior (NNNS) between groups. Conclusions: This pilot study found that 2′-FL supplementation in preterm infants through 36 weeks corrected GA was safe and well-tolerated and supported adequate growth and neurobehavior.

Nutrients doi: 10.3390/nu18152436

Authors: Daria Kupczyk Rafał Bilski Igor Kozieł Agata Słota Mateusz Kurek Emilia Stablewska Szymon Baumgart Artur Słomka Renata Studzińska

Population aging is a growing problem. This process is driven not only by genetic factors but also by environmental factors, such as diet. Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the leading cause of dementia worldwide, characterized by cognitive decline, synaptic dysfunction, and neuronal loss. Despite extensive research, effective disease-modifying therapies remain limited. Increasing evidence indicates that oxidative stress plays a central role in AD pathogenesis, acting as a key link between β-amyloid accumulation, tau hyperphosphorylation, mitochondrial dysfunction, and neuroinflammation. Accordingly, dietary strategies have been proposed to mitigate these pathological processes and may represent an important component of Alzheimer’s disease prevention. Moreover, emerging evidence on the gut–brain axis highlights the critical role of gut microbiota in regulating neuroinflammation and oxidative stress. Dysbiosis has been associated with increased permeability of the intestinal barrier, systemic inflammation, and accelerated neurodegeneration. Dietary patterns such as the Mediterranean, DASH, and MIND diets may exert beneficial effects by simultaneously influencing antioxidant status and microbial composition. This review aims to provide a comprehensive overview of the role of oxidative stress in Alzheimer’s disease and evaluate the potential of dietary interventions in modulating mechanisms involved in Alzheimer’s disease pathogenesis and supporting cognitive health. Particular attention is given to the neuroprotective effects of dietary antioxidants, including vitamins, polyphenols, and polyunsaturated fatty acids, which act through the reduction in reactive oxygen species, modulation of inflammatory pathways, and support of neuronal survival. Although current findings are promising, inconsistencies in clinical data indicate the need for further well-designed studies. Future research should focus on personalized nutritional strategies integrating dietary, genetic, and microbiome-related factors. Targeting oxidative stress through diet and microbiota modulation represents a promising complementary strategy for Alzheimer’s disease prevention and supportive management, although further clinical studies are required to establish disease-modifying effects.

Nutrients doi: 10.3390/nu18152435

Authors: Shooka Mohammadi Andrea Palermo Pantea Ojani Navid Alaghemand Pouyan Sanjari Pirayvatlou Mohammadreza Mirkarimi Sara Ayazian Mavi Kia Tahouri Shokoufeh Shokouhifar Yeganeh Ettehad Aida Borzabadi Damoon Ashtary-Larky Katsuhiko Suzuki Cristina Bouzas Daniela Rodrigues Josep A. Tur

Background: Evidence regarding the impacts of magnesium (Mg) supplementation on cardiometabolic risk factors (CMRFs) remains inconsistent. Objectives: This systematic review and dose–response meta-analysis evaluated effects of Mg supplementation on anthropometric indices, liver and kidney function, lipid and glycemic profiles, blood pressure, and inflammatory biomarkers. Methods: A systematic search of electronic databases up to May 2026 identified 78 eligible randomized controlled trials. Results: Mg supplementation significantly reduced body weight (weighted mean difference [WMD]: −0.70 kg; 95% confidence interval [CI]: −1.30, −0.09), diastolic blood pressure (WMD: −1.58 mmHg; 95% CI: −2.50, −0.65), homeostasis model assessment of insulin resistance (WMD: −0.48; 95% CI: −0.79, −0.18), low-density lipoprotein cholesterol (WMD: −3.21 mg/dL; 95% CI: −5.27, −1.15), fasting blood glucose (WMD: −3.60 mg/dL; 95% CI: −6.13, −1.06), systolic blood pressure (WMD: −2.50 mmHg; 95% CI: −4.08, −0.91), glycated hemoglobin (WMD: −0.15%; 95% CI: −0.26, −0.03), triglycerides (WMD: −9.24 mg/dL; 95% CI: −16.87, −1.61), and interleukin-6 levels (WMD: −1.10 pg/mL; 95% CI: −1.93, −0.27) compared with controls. High-density lipoprotein cholesterol concentrations significantly increased (WMD: 1.45 mg/dL; 95% CI: 0.37, 2.54). No significant effects were identified on hip circumference, alanine aminotransferase, waist circumference, tumor necrosis factor-α, creatinine, C-reactive protein, body mass index, total cholesterol, fasting insulin, body fat percentage, and aspartate aminotransferase. Most RCTs (79.5%) administered Mg doses ≥ 300 mg/day, and 66.7% had intervention durations ≥ 12 weeks; however, evidence from higher-dose (≥500 mg/day) and longer-term (≥25 weeks) interventions remained limited. Conclusions: Mg supplementation was associated with significant improvements in several CMRFs, including body weight, lipid and glycemic profiles, blood pressure, and interleukin-6 levels. However, these effects were generally modest, and their clinical relevance remains uncertain given the variable certainty of evidence across outcomes.

Nutrients doi: 10.3390/nu18152434

Authors: Olga Alexatou Sousana K. Papadopoulou Exakousti-Petroula Angelakou Athanasios Migdanis Maria Mentzelou Ioannis Migdanis Aikaterini Louka Aspasia Serdari Constantinos Giaginis

Background/Objectives: Perceived stress and sleep quality are increasingly recognized as important determinants of emotional eating (EE), particularly among university students who are frequently exposed to academic pressures, psychosocial challenges, and lifestyle disruptions. Both stress and sleep quality are closely interconnected, with elevated stress contributing to sleep disturbances and poor sleep further exacerbating psychological distress. The present study aims to simultaneously examine the independent contributions of perceived stress and sleep quality to EE while accounting for other relevant sociodemographic, lifestyle, and anthropometric factors. Methods: This cross-sectional study was conducted among 1297 university students recruited from 10 geographical regions of Greece. Data on sociodemographic characteristics, academic profile, lifestyle behaviors, and anthropometric parameters were collected using standardized and validated assessment instruments. Perceived stress was measured using the Perceived Stress Scale (PSS), while sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Emotional eating was assessed using the Emotional Eating subscale of the Three-Factor Eating Questionnaire–Revised 18 (TFEQ-R18), and participants were subsequently classified into tertiles corresponding to low, moderate, and high levels of emotional eating. Results: Perceived stress was independently associated with EE in the multivariable analysis. Compared with students reporting low levels of stress, those experiencing high perceived stress exhibited almost threefold greater odds of being classified in higher emotional eating categories (OR = 2.86; p = 0.0001). Likewise, participants with moderate perceived stress were approximately twice as likely to demonstrate elevated emotional eating levels relative to their low-stress counterparts (OR = 2.01; p = 0.0001). Sleep quality was also independently associated with EE after adjustment for potential confounding factors. Specifically, students characterized by inadequate sleep quality had more than three times the likelihood of belonging to higher emotional eating categories compared with those reporting satisfactory sleep quality (OR = 3.08; p = 0.0001). The multivariable model demonstrated good fit (Likelihood Ratio Test, p < 0.001), and the proportional odds assumption was satisfied (p = 0.46). Conclusions: These findings underscore the important role of psychological distress and sleep health in EE behavior, independent of other sociodemographic, academic, lifestyle, and anthropometric factors. Given the observed associations, interventions incorporating stress-management and sleep-improvement components may represent promising approaches for addressing emotional eating among university students; however, longitudinal and intervention studies are needed to establish causality. Future longitudinal and intervention studies are needed to establish causality among perceived stress, sleep quality, and emotional eating.

Nutrients doi: 10.3390/nu18152433

Authors: Elisa Mattavelli Emanuele Cereda Alessandro Amorosi Saba Ancillai Anna Boggio Marco Danova Gabriella Farina Monica Giordano Patrizia Gnagnarella Elisa Merelli Giulia Mulazzani Paolo Pedrazzoli Piero Rivizzigno Alessandro Scardoni Alessandro Zucchelli Riccardo Caccialanza on behalf of the Clinical Nutrition Network of Lombardy on behalf of the Clinical Nutrition Network of Lombardy

Background: Malnutrition is common among patients with cancer and is associated with poorer clinical outcomes and increased healthcare costs. However, nutritional care remains suboptimal in routine oncology practice. This study aimed to assess the implementation of nutritional screening, assessment and management across oncology centers in Lombardy (Italy) and to identify critical areas to support the development and implementation of a regional Diagnostic–Therapeutic Care Pathway (PDTA). Methods: A 21-item questionnaire developed by the Oncology Commission of the Clinical Nutrition Network of Lombardy Region was administered to all regional oncology centers. Data were collected via the Welfare General Directorate platform from 13 November 2024 to 31 December 2024, and analyzed in aggregate form. Results: In total, 55 out of 59 centers responded (93.2%). Nutritional care was available in 78% of centers. Systematic nutritional risk screening was reported by 42% of centers, while 51% performed a comprehensive nutritional assessment in all patients with a positive screening result. Nutritional assessment was scheduled at both initial and follow-up visits in 53% of centers. In the perioperative setting, prehabilitation programs were available in 49% of centers, and preoperative immunonutrition was administered in 35%. Tools for assessing patient-reported outcomes and quality of life were available in only 15% and 20% of centers, respectively. Conclusions: The survey suggests some improvements compared to previous Italian surveys but highlights persistent gaps in the organization and delivery of nutritional care for patients with cancer.

Nutrients doi: 10.3390/nu18152432

Authors: Rachael A. Simpson Umesh K. Shandilya Lauri C. Wagter-Lesperance Byram W. Bridle Bonnie A. Mallard Niel A. Karrow

Iodine is an essential micronutrient required for coordinating thyroid hormone synthesis, growth, neurodevelopment, metabolism, and immune function across humans and domesticated mammals. Molecular iodine can act as an antioxidant, anti-inflammatory, and anti-proliferative agent in several tissues, but these mechanistic effects require confirmation in well-designed human studies. Recommended intakes fall within a narrow optimal range, reflecting a U-shaped response curve in which adequate intake supports systemic homeostasis, while both deficient and excessive intakes can impact immune function. Chronic deficiency impairs neurodevelopment and reproductive performance and weakens the host microbial defences, while sustained excess promotes oxidative stress, alters cytokine profiles, and in genetically susceptible individuals, increases the risk of subclinical or overt thyroid dysfunction and autoimmune thyroid disease. This review summarizes iodine nutrikinetics, dose-dependent outcomes and susceptibility in humans and domesticated mammalian species, emphasizing the importance of maintaining appropriate iodine status to support immunocompetence while minimizing adverse effects.

Nutrients doi: 10.3390/nu18152431

Authors: Yansong Fu Xin Zeng Bin Zhou Jiayun Wang Hong Qin

Background/Objectives: In obese skeletal muscle, impaired insulin signalling and persistent low-grade inflammation frequently arise together, jointly driving metabolic dysfunction; yet a single intracellular node capable of simultaneously correcting both defects has not been identified. Curcumol is the principal active sesquiterpene of the traditional Chinese herb Curcuma zedoaria (Christm.) Rosc. We therefore sought to determine whether curcumol modulates obesity-driven insulin resistance and inflammatory activation in skeletal muscle, and to delineate the responsible molecular pathway. Methods: The study combined in vivo and in vitro experiments with network pharmacology, molecular docking, pharmacological inhibition, and cellular thermal shift assay (CETSA). In vivo experiments used mice rendered obese by prolonged high-fat diet (HFD) feeding; in vitro, insulin resistance was modelled in C2C12 myotubes via palmitate challenge. Network pharmacology implicated SRC as a principal candidate target, and molecular docking assigned SRC kinase the highest binding affinity for curcumol. Selective blockade of SRC (PP2) and PI3K (LY294002) was used to delineate the signalling hierarchy. Results: Network pharmacology and molecular docking identified SRC kinase as the highest-ranked candidate target of curcumol. In both HFD-induced obese mice and palmitate-challenged C2C12 myotubes, curcumol restored SRC phosphorylation and activated the downstream PI3K/AKT axis, concurrently improving insulin sensitivity and attenuating NF-kB-driven inflammatory responses. Selective PI3K inhibition abolished all functional benefits of curcumol without altering SRC phosphorylation, whereas SRC blockade with PP2 prevented both PI3K/AKT activation and the downstream recovery of insulin sensitivity and inflammatory suppression, placing SRC upstream of PI3K/AKT in the signalling order. Direct binding of curcumol to SRC protein was confirmed by a cellular thermal shift assay. Conclusions: Curcumol directly engages SRC kinase and, through subsequent PI3K/AKT axis activation, concurrently rescues skeletal muscle insulin sensitivity and suppresses metabolic inflammation. These findings provide mechanistic justification for developing curcumol as a candidate dietary bioactive compound toward preventing and treating obesity-related metabolic disturbances.

Nutrients doi: 10.3390/nu18152430

Authors: Yanling Lv Feiyang Zhao Yaqi Zhang Zekun Zheng Cunpeng Hou Guanhua Jiang Shan Lin Liegang Liu Liangkai Chen

Background and Purpose: Ultra-processed food (UPF) intake is a risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD) development, and fibroblast growth factor 21 (FGF21) is a key regulator of hepatic lipid metabolism, but its role in this association remains unclear. We aimed to investigate whether FGF21 mediates the UPF-MASLD relationship in a population-based cohort and whether berry extract (BE) protects against UPF-related liver injury through FGF21 signaling. Methods: This study included 29,386 participants with magnetic resonance imaging (MRI)-derived proton density fat fraction (PDFF) and iron-corrected T1 (cT1) from the UK Biobank. UPF intake was classified according to the NOVA system. Log-binomial and generalized linear regression models were used to estimate the associations of UPF with MASLD, PDFF, and cT1, respectively. In vivo, nine-month-old male C57BL/6J mice were fed a baked Western diet (BWD) with bilberry extract (BE, 200 mg/kg/day) or vehicle for 16 weeks. In vitro, the role of FGF21 was examined by knockdown experiments in AML12 hepatocytes. Results: UPF consumption was linearly associated with a higher risk of MASLD, with per 10% increment associated with 9% higher risk of MASLD (RR 1.09 [95% CI 1.07–1.10]), as well as dose-dependent increases in PDFF and cT1. Among the 283 plasma proteins associated with PDFF, FGF21 showed the strongest association with UPF intake and accounted for the largest proportion of mediation in the UPF-PDFF association. A significant interaction between UPF and berry intake was observed in MASLD risk (p for interaction = 0.018). In the animal model, BE supplementation for 16 weeks alleviated BWD-induced hepatic steatosis, inflammation, and glucose intolerance, while upregulating hepatic FGF21, FGFR1c, and β-Klotho expression and improving mitochondrial function. FGF21 knockdown abrogated BE’s protective effect against lipid accumulation in vitro. Conclusions: FGF21 emerged as a potential mediator of the association between UPF consumption and liver fat accumulation. Anthocyanin-rich dietary interventions may offer a promising strategy to prevent MASLD progression.

Nutrients doi: 10.3390/nu18152429

Authors: Hai Li Ming Chen Mingnan Zhuang Hengzhi Deng Haiying Wang Hansen Li

Background and Objectives: Evidence on the acute effects of caffeine in female team-sport athletes is limited. This study aimed to quantify the acute effects of caffeine on female team-sport athletes across physical performance, sport-specific performance, physiological responses, perceptual responses, and cognitive performance and determine moderators. Methods: PubMed and Web of Science were systematically searched for randomized, placebo-controlled crossover trials of acute, dose-defined caffeine in female team-sport athletes. Effect sizes were expressed as Hedges’ g and synthesized within each domain using a three-level CHE model with CR2 cluster-robust variance estimation and Satterthwaite degrees of freedom; 95% confidence intervals and prediction intervals were reported. Risk of bias (RoB 2), methodological quality (PEDro), and certainty of evidence (GRADE) were assessed. Results: Twenty-six studies were included, comprising 26 randomized, blind, placebo-controlled crossover trials. As a descriptive cross-domain summary, acute caffeine intake showed a small overall effect when all available domains were pooled (Hedges’ g = 0.24, 95% CI 0.13 to 0.35); however, because these domains represent different constructs, domain-specific estimates were considered the primary interpretable findings. For physical performance, caffeine showed a small favorable effect (g = 0.32, 95% CI 0.22 to 0.42), with statistical evidence for repeated sprint ability (g = 0.43), agility or change in direction (g = 0.42), sprint or speed performance (g = 0.39), anaerobic power (g = 0.30), and jumping performance (g = 0.29). For sport-specific performance, the pooled estimate indicated a small favorable effect but did not reach conventional statistical significance (g = 0.36, 95% CI: −0.01 to 0.73). Exploratory sub-indicator analyses, each based on only a few studies, suggested possible favorable directions for sport-specific locomotion or running performance (g = 0.46) and throwing or ball-speed outcomes (g = 0.19), whereas evidence was insufficient for shooting or scoring accuracy. Physiological outcomes were direction-aligned to the value conventionally regarded as favourable for each indicator (i.e., lower heart rate, lactate, and glucose), so that positive values denote the conventionally favourable direction; because the domain aggregates indicators of differing clinical desirability, its pooled value is a descriptive summary only and showed no clear domain-level direction (g = −0.05, 95% CI −0.31 to 0.21). The heart rate submetric showed a statistically detectable difference (g = −0.30), indicating that caffeine increased heart rate, the expected pharmacological response to a stimulant rather than an adverse effect; there were no clear effects on blood lactate or blood glucose. Perceptual responses improved modestly (g = 0.42), largely through reduced rating of perceived exertion (g = 0.35). Cognitive performance, based on only four studies with low degrees of freedom and wide uncertainty, showed a nonsignificant direction (g = 0.37) with no clear evidence for reaction time or cognitive accuracy, and these data should not be interpreted as showing that caffeine improves cognitive performance in female team-sport athletes. Exploratory moderator analyses did not provide statistically reliable evidence of moderation by caffeine dose, timing of intake, formulation or source, sport type, competitive level, habitual caffeine intake, or blinding status. Conclusions: Available evidence most consistently supports small, outcome-specific benefits of acute caffeine for physical performance and reduced perceived exertion. Evidence for sport-specific skills and cognitive outcomes remained uncertain, based on few studies per outcome and not supporting a general benefit. Current data do not support dose-, timing-, formulation-, habitual-intake-, sport-, or population-stratified recommendations. Future trials should be adequately powered, prospectively report menstrual-cycle phase, hormonal-contraceptive use, habitual caffeine intake, and adverse symptoms, and verify the integrity of blinding.

Nutrients doi: 10.3390/nu18152428

Authors: Vineela Vepakomma Basanth Geereddy Saanvi S. Singireddy Soumya R. Gurrala Karthikeyan Ramanujam G. Bhanuprakash Reddy

Background: Mild cognitive impairment (MCI) represents an intermediate state between normal cognitive ageing and dementia. Given the increasing dementia burden in the country, there is a critical need for early detection through the assessment of MCI. However, studies that comprehensively examined the associations between micronutrients, neuronal markers, and cognitive impairment are scarce. Methods: A community-based cross-sectional study was conducted among 184 adults aged 55–85 years in Hyderabad between January 2024 and March 2025. Sociodemographic, anthropometric, biochemical, nutritional, and neuronal biomarkers were estimated. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) tool. Results: The study reported an MCI prevalence of 36.4% among older adults, significantly associated with higher HbA1c and systolic blood pressure, and elevated neuronal markers such as β-Amyloid, T tau, and Nfl. Vitamin D, B1, B2, B6, and B9 levels were significantly lower in the MCI group, with a higher burden of deficiency. Higher vitamin levels were correlated with better MoCA scores and a lower predicted probability of MCI, especially vitamins D and B6. In particular, B2 and B6 have shown associations with BDNF, tau, and Nfl markers. Conclusions: Lower levels of circulatory vitamins were significantly associated with a higher probability of MCI. Also, neuronal biomarkers were significantly associated with micronutrient deficiencies. These findings suggest that micronutrient deficiencies may be associated with MCI in older adults, highlighting the potential importance of maintaining adequate micronutrient status to support healthy cognitive aging and possibly reduce the risk of dementia. However, given the cross-sectional design of the present study, causal relationships cannot be established. Future longitudinal studies are warranted to validate these associations and further clarify the temporal relationship between micronutrient status and cognitive decline.

Nutrients doi: 10.3390/nu18152427

Authors: Vincenzo Aiello Leonardo Lupacchini Manuel Belli Mario Cristina Luigi Sansone Gabriele Di Marco Angelo Gismondi Alessandro Pennesi Maria Rosa Ciriolo Serena Castelli Sara Baldelli

Background/Objectives: Sarcopenia involves a gradual decline in skeletal muscle mass that may occur during aging or in association with chronic pathological conditions. It markedly reduces muscle strength and mobility, thereby impairing quality of life. Because sarcopenia’s severity directly correlates with frailty, it represents an important predictor of prognosis and disease risk. Current preventive and therapeutic strategies rely mainly on physical activity, which is not feasible for all patients. This study investigated the biological effects of two independently prepared Tuber borchii (T. borchii) extracts in an in vitro model of sarcopenic stress. Methods: The activity of T. borchii extracts was investigated in a cell-based model of sarcopenia, following previous observations that these preparations influence proliferation-related pathways, including ERK1/2 phosphorylation. Specifically, differentiated myotubes were exposed to D-galactose to reproduce atrophy-associated cellular changes, and the impact of T. borchii extracts on protein synthesis, turnover, and cell morphology was assessed. Results: T. borchii extracts enhanced protein synthesis and turnover in myotubes. Furthermore, the treatment significantly reduced the expression of key galactose-induced sarcopenia and atrophy markers, such as MuRF1. Morphological analysis confirmed this protective effect, showing that treated myotubes maintained greater thickness and exhibited a larger cross-sectional area despite exposure to the sarcopenic stimulus. Conclusions: These results indicate that T. borchii extracts can attenuate selected cellular alterations associated with muscle aging. Future identification of the most active components may support their development as nutraceutical supplements.

Nutrients doi: 10.3390/nu18152424

Authors: Sujin Song Yan Wang Lucas Atwood Nirav R. Shah Reza A. Jarral

Background/Objectives: This decentralized, real-world observational cohort study assessed whether Cheers Restore (Houston, TX, USA), a commercially available dietary supplement, is associated with improved next-day subjective well-being (energy, mental clarity, physical well-being, and sleep quality) following alcohol consumption in healthy adults. A secondary aim evaluated the feasibility of integrating consumer wearables into future controlled studies. Methods: Ninety adults (56% female; mean age 44.4 years) were enrolled via the Alethios digital research platform and contributed 2958 morning surveys across three self-selected behavioral conditions: Alcohol-Only (reference), Cheers Restore, and Non-Drinking Baseline. Four subjective outcomes (energy, mental clarity, physical well-being, sleep quality rating; 1–10 scale) were modeled using linear mixed-effects models with random intercepts for participant and centered drink count as a covariate. Results: Cheers Restore use was associated with statistically significant improvements across all four subjective outcomes relative to alcohol-only nights: mental clarity (β = 0.356, 95% CI 0.214–0.499, p < 0.001), physical well-being (β = 0.335, 95% CI 0.189–0.482, p < 0.001), energy (β = 0.270, 95% CI 0.133–0.407, p < 0.001), and sleep quality rating (β = 0.263, 95% CI 0.096–0.430, p = 0.002). Standardized effect sizes were small (Cohen’s d = 0.20–0.32). Paired Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) analysis confirmed stable consumption with no evidence of increased alcohol consumption over the short, self-reported follow-up. Conclusions: In this observational cohort, Cheers Restore use was associated with consistent improvements in next-day subjective well-being. These findings warrant a randomized, placebo-controlled trial to establish causality. ClinicalTrials.gov: NCT07069608, registered 16 July 2025.

Nutrients doi: 10.3390/nu18152425

Authors: Alberto Vicente-Prieto Cristina Lugones-Sánchez Sara Vicente-Gabriel Cristina Saldaña-Ruiz Susana González-Sánchez Sandra Conde-Martín Manuel A. Gómez-Marcos Marta Gómez-Sánchez Leticia Gómez-Sánchez EVA-Adic Investigators Group

Background/Objectives: Problematic digital technology use may be associated with unhealthy dietary behaviors, but different forms of digital dependence may not relate to diet quality in the same way. This study examined the association between Mediterranean diet adherence and problematic smartphone, Internet, and video game use in young adults. Methods: A cross-sectional study was conducted in 496 adults aged 18–34 years participating in the EVA-Adic study. Mediterranean diet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). Problematic digital use was evaluated using the EDAS-18 for smartphone dependence, the Compulsive Internet Use Scale (CIUS), and the Questionnaire of Experiences Related to Video Games (CERV). Multivariable regression models were adjusted for sociodemographic, anthropometric, and lifestyle factors. Results: Of the participants, 339 had low-to-moderate Mediterranean diet adherence, and 157 had high adherence. In fully adjusted models, higher EDAS-18 scores were associated with lower MEDAS scores (β = −0.022; 95% CI: −0.041 to −0.003), whereas higher CIUS scores showed a small positive association with MEDAS scores (β = 0.025; 95% CI: 0.002 to 0.049). CERV scores and the global digital addiction index were not associated with overall Mediterranean diet adherence. At the individual dietary-component level, higher smartphone dependence was associated with lower compliance with fruit and sugar-sweetened beverage recommendations. Conclusions: In this cross-sectional sample of young adults, smartphone dependence and compulsive Internet use showed small associations with Mediterranean diet adherence in opposite directions, whereas problematic video-game use and the exploratory global composite were not associated with the overall MEDAS-14 score. The magnitude of the observed associations was modest; their clinical and public-health relevance remains uncertain, and the component-level findings should be considered exploratory in the context of multiple testing. These results do not establish causality and require confirmation in longitudinal, multicenter studies using objective and context-specific measures of digital use.

Nutrients doi: 10.3390/nu18152426

Authors: Bilal Tulumcu Richard Ivell Ravinder Anand-Ivell

Background/Objectives: Circulating insulin-like peptide 3 (INSL3) is a constitutively secreted product of mature Leydig cells and is considered a stable biomarker of Leydig cell functional capacity, a key determinant of androgenic status across the male lifespan. Since the adult Leydig cell population is established during late childhood and puberty, nutritional and metabolic exposures during these periods may contribute to later variation in young adult INSL3. To investigate whether childhood and adolescent nutritional/metabolic markers, particularly vitamin D, fatty acids, amino acids, and dietary trace-element intake, are associated with circulating INSL3 concentrations in young adulthood. Methods: Data were analysed from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based UK birth cohort. Nutritional and metabolic markers measured during childhood and adolescence included vitamin D, fatty acid-related traits, glutamine, leucine, dietary zinc intake, and dietary selenium intake. Associations with circulating INSL3 at 17 and 24 years were first explored using bivariate correlation analysis. Variables showing signals of interest were then examined in multiple linear regression models using log-transformed data and relevant covariates, including BMI at 8 years and log-transformed exact age at the age-24 clinic visit. Results: Among the variables examined, vitamin D at 9 years showed a small positive association with INSL3 at 24 years (r = 0.098, n = 735, p = 0.008), remaining below the corrected threshold after both Benjamini–Hochberg and Bonferroni correction (q = 0.032 and Bonferroni-adjusted p = 0.032). This relationship remained evident after adjustment for BMI at 8 years and after further adjustment for log-transformed exact age at the age-24 clinic visit. In these multivariable models, BMI at 8 years showed little evidence of association with INSL3 at 24 years, whereas log-transformed exact age at the age-24 clinic visit showed a negative association with INSL3. In contrast, no meaningful associations were observed for fatty-acid-related measures. Among amino acids and dietary trace-element measures, glutamine at 17 years showed a weak nominal positive association with INSL3 at 24 years, but this did not remain below the threshold after multiple-testing correction. Conclusions: Childhood vitamin D status, particularly at 9 years of age, may represent an early-life factor associated with variation in adult Leydig cell functional capacity. Fatty acid-related measures showed no clear associations, while glutamine yielded only a weak exploratory signal. These findings support the concept that the childhood metabolic environment may influence the developmental establishment of adult Leydig cell capacity.

Nutrients doi: 10.3390/nu18152423

Authors: Georgia Lagodonti Dimitrios Kalompatsios Panagiotis Varagiannis Vassilis Athanasiadis Stavros I. Lalas

Background/Objectives: Male infertility is a growing public health concern, with lifestyle and dietary factors increasingly recognized as contributors to impaired sperm function. Oxidative stress plays a central role in sperm damage, yet the relationship between seminal antioxidant capacity, dietary antioxidant intake and semen quality remains unclear. This study investigated the association between seminal plasma antioxidant status, sperm quality parameters and dietary antioxidant intake, while accounting for key lifestyle factors. Methods: A total of 105 men (18–55 years) undergoing semen analysis were enrolled. Semen parameters were evaluated according to the WHO guidelines. Seminal plasma antioxidant capacity was assessed using the Ferric Reducing Antioxidant Power (FRAP) and DPPH radical scavenging assays. Dietary antioxidant intake was estimated using a validated food frequency questionnaire, and lifestyle factors (smoking, alcohol consumption, physical activity, supplement use) were recorded. Correlations and multivariable regression models were applied to examine associations between antioxidant indices and semen quality. Results: Seminal antioxidant capacity showed wide inter-individual variability (FRAP: 1.6–2171.4 μmol Trolox eq/L; DPPH: 28.5–3093.2 μmol Trolox eq/L). Dietary antioxidant intake demonstrated very weak correlations with semen parameters (r < 0.20). Regression analyses identified smoking and higher body weight as strong negative predictors of sperm concentration, total count and motility, whereas physical activity was positively associated with morphology and progressive motility. FRAP exhibited a mixed association with motility subtypes, while supplement use was positively associated with vitality. Conclusions: Lifestyle factors—particularly smoking, body weight and physical activity—were stronger determinants of semen quality than dietary antioxidant intake or seminal antioxidant indices. These findings highlight the importance of modifiable behaviors in male reproductive health and suggest that improving lifestyle habits may offer greater benefits than dietary antioxidant intake alone.

Nutrients doi: 10.3390/nu18152422

Authors: Jean Demarquoy

Front-of-pack nutrition labeling systems have become important tools for improving consumer understanding of nutritional information and supporting healthier food choices. Among these systems, Nutri-Score has emerged as one of the most widely implemented nutrient profiling models in Europe. Based on the Food Standards Agency Nutrient Profiling System, Nutri-Score summarizes selected nutritional characteristics of foods through a simplified five-level color-coded scale. A growing body of evidence indicates that Nutri-Score improves consumers’ ability to compare products, supports healthier purchasing decisions, and may encourage product reformulation. Epidemiological studies have reported associations between dietary patterns characterized by less favorable nutrient profile scores and increased risks of chronic diseases and mortality. Despite these strengths, important scientific and conceptual questions remain. This review examines the principles of nutrient profiling and assesses how effectively food quality can be represented by a limited set of nutritional criteria. Particular attention is given to nutrient reductionism, the use of the standardized 100 g reference, food matrix effects, the relationship between nutrient profiling and food processing, the influence of hedonic drivers and health claims on consumer behavior, and the growing importance of environmental contaminants as dimensions of food quality not captured by current algorithms. Future food evaluation systems may benefit from integrating complementary information related to food structure, processing characteristics, dietary context, and emerging insights from systems nutrition.

Nutrients doi: 10.3390/nu18152421

Authors: Starska-Kowarska Katarzyna

Head and neck cancer (HNC) comprises a heterogeneous group of tumours, most often of squamous cell origin, characterized by both high morbidity and mortality rates. It is the seventh most common form of cancer diagnosed in humans, accounting for approximately 4.7% of all cancers. Among HNCs, neck squamous cell carcinoma (HNSCC) is predicted to become the most common form of human cancer. Some sources include oesophagus (ESCC) in this group due to their similar histology, being described as upper aerodigestive tract cancers (UADT). Unfortunately, 60–70% of cases are diagnosed late, i.e., at clinical stages III-IV. As a result, despite modern surgical techniques and oncological treatments, the survival rate remains below 40–60% due to frequent lymph node metastases and local tumour recurrence. There is a growing concern that diet and inflammatory dietary components may influence the initiation and development of HNSCC. The inflammatory potential of diets can be quantified by the Dietary Inflammatory Index (DII). The DII was derived from an analysis of 45 dietary constituents that either increase or decrease inflammation. Several recent clinical studies have noted a significant relationship between DII score and many inflammation-associated chronic diseases, such as obesity, cardiovascular and neurodegenerative disorders, and diabetes, and the incidence of various human cancers, i.e., prostate, ovarian, breast, colorectal cancer, and HNC. However, few studies have investigated the relationship between DII and HNSCC, with most being limited to observational, case-control, and cross-sectional studies. Therefore, the aim of this narrative review is to present the substantial oncological aspects of DII, discuss the use of DII and its modification, the Energy-Adjusted Dietary Inflammatory Index (E-DII), as indicators of HNSCC risk. It also introduces key diet-induced pro- and anti-inflammatory mechanisms and the cellular molecular signalling pathways determining the carcinogenesis of HNSCC. It provides a comprehensive overview of the current literature, including key opinion-forming systematic reviews, as well as molecular, observational, cross-sectional and case-control studies, all of which are accessible via scholarly databases such as PubMed/EMBASE/Web of Science. Thus, the work serves as a compendium of up-to-date knowledge on the relationship between DII/ED-II score and HNSCC etiopathogenesis and the influence of a diet-induced persistent inflammatory microenvironment.

Nutrients doi: 10.3390/nu18152420

Authors: Fernandes Daieni Berbigier Marina Carvalho Soares Cássia Medino Spritzer Poli Mara Marschner Rafael Aguiar Wajner Simone Magagnin Ferreira Samanta Catherine Dall Alba Valesca

Background: Post-COVID-19 condition (PCC) remains a public health concern due to persistent metabolic and inflammatory alterations, especially among ICU survivors. Oxidative stress is involved in PCC pathophysiology, and the Mediterranean diet may be associated with redox balance. Objective: To evaluate the association between Mediterranean diet adherence (main exposure variable) and oxidative stress/redox stress biomarkers (primary outcomes) in ICU survivors with persistent symptoms after severe COVID-19. Additionally, body composition and inflammatory markers were explored as secondary outcomes related to redox status. Methods: This cross-sectional study included 123 adult ICU survivors with PCC (51 ± 13.2 years; 53% men; 75% with obesity). Protein carbonyls, TBARS, sulfhydryl groups, glutathione, CRP, albumin, and IL-6 were measured. Diet adherence during post-COVID-19 outpatient follow-up was assessed using MEDAS, and body composition by DXA. Participants were categorized by the median score, and Poisson regression models were applied. Results: The median MEDAS total score was 4 (IQR 2–5), indicating overall low adherence to the Mediterranean diet. Lower adherence was associated with higher glutathione levels (p = 0.04), with no differences in pro-oxidant markers. Higher sulfhydryl levels were associated with lower body fat, higher appendicular skeletal muscle mass, and lower CRP and IL-6. Conclusions: Low adherence was frequent and associated with antioxidant differences. Redox status was also associated with body composition and inflammatory markers.

Nutrients doi: 10.3390/nu18152419

Authors: Yu-Syuan Lin Zhen-Shu Liu Yu-Jie Yang Po-Wen Chen

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease involving barrier dysfunction, pruritus, and immune dysregulation, and microbial-based interventions are being explored as supportive approaches. This study first conducted an exploratory pilot model-development experiment to characterize DNCB-induced dermatitis-like inflammation and subsequently compared oral live Lactobacillus, heat-killed Lactobacillus (paraprobiotics), and a combined live/heat-killed formulation after disease induction. Methods: Male BALB/c mice received repeated topical DNCB exposure followed by 21 days of oral intervention. Outcomes included gross lesion scores, cumulative scratching time, ear and spleen indices, histopathology, qualitative mast-cell staining in the therapeutic experiment, and serum IgE, IL-4, and IFN-γ. Longitudinal gross scores were reanalyzed using generalized estimating equations with group, time, and group-by-time interaction. Results: After Holm correction, the mixed formulation showed a lower left-ear erythema score than placebo at Week 2, whereas no other intervention-versus-placebo gross-score comparison remained significant. Paraprobiotic and mixed formulations reduced spleen weight, but histopathological and serum biomarker responses were variable. Conclusions: These findings indicate partial, endpoint-dependent effects of live and heat-killed Lactobacillus formulations in DNCB-induced dermatitis-like inflammation.

Nutrients doi: 10.3390/nu18152418

Authors: Azzurra Annunziata Artur Kraus Angela Mariani

Background: Cultured meat (CM) has emerged as a promising, albeit controversial, alternative to conventional livestock production, offering potential benefits in terms of sustainability, animal welfare, and resource efficiency. Despite these potential advantages, consumer acceptance remains uncertain, particularly in countries where CM is not yet commercially available. Objectives: this study investigates the determinants of willingness to try (WTT) cultured meat among Italian university students (n = 335), with particular attention to the role of product-related perceptions and personal values and motivations. Methods: data were collected through an online survey and analyzed using binary logistic regression to identify the main drivers of respondents’ willingness to try CM. Results: the findings suggest that acceptance of CM among university students is driven primarily by familiarity, perceived safety, and ethical considerations, particularly those related to animal welfare, rather than by demographic characteristics or resistance to novel food technologies. Conclusions: these findings offer practical implications for policymakers and industry stakeholders, highlighting the importance of transparent communication strategies emphasizing product safety and animal welfare benefits as a means of increasing familiarity with and acceptance of CM among younger consumers.

Nutrients doi: 10.3390/nu18152417

Authors: Sandro La Vignera Rosita A. Condorelli

Background/Objectives: Male obesity secondary hypogonadism (MOSH) is a highly prevalent condition characterised by reduced testosterone levels in obese men, driven by increased aromatase activity, reduced SHBG, insulin resistance, and HPG axis suppression. Dietary interventions represent a cornerstone of non-pharmacological management; however, the comparative efficacy of different dietary patterns on testosterone restoration remains unclear. Methods: We conducted a systematic literature review following PRISMA 2020 guidelines. Comprehensive searches were performed in SciSpace, Google Scholar, and PubMed through June 2026. Eligible studies included human adult males with obesity (BMI ≥ 30 kg/m2) undergoing Mediterranean diet (MedDiet), ketogenic diet (KD/VLCKD), or intermittent fasting (IF) interventions, with quantitative assessment of testosterone or androgen status. Results: From 697 initial records, 500 unique papers were identified after deduplication. Following abstract screening (n = 442 excluded) and full-text assessment (n = 6 excluded), 52 studies were included in the final synthesis. VLCKD demonstrated the most consistent evidence for testosterone improvement, with RCTs reporting significant increases in total testosterone (+1.5 to +3.0 nmol/L). Intermittent fasting showed promising but more heterogeneous results. Evidence for Mediterranean diet was limited, focusing primarily on metabolic rather than hormonal outcomes. Weight loss emerged as a critical mediator across all dietary interventions (~3 nmol/L per 10 kg weight loss). Conclusions: Among dietary interventions for MOSH, VLCKD shows the strongest evidence for testosterone restoration in obese men, through rapid weight loss, improved insulin sensitivity, reduced inflammation, and potential direct HPG axis effects. Intermittent fasting represents a viable alternative. Mediterranean diet, while beneficial for cardiovascular health, lacks robust interventional evidence for testosterone improvement in this population. Systematic Review Registration: This review was not prospectively registered. PROSPERO registration is recommended for future updates.

Nutrients doi: 10.3390/nu18152416

Authors: Muhammad Maaz Muhammad Tauseef Sultan Ahmad Mujtaba Noman Ralf Weiskirchen Waleed Rizk ElGhareeb Bodour Ibrahim Al Shik Mubarak Adel A. Rezk Marwa Ezz El-Din Ibrahim

Background/Objectives: Extra virgin olive oil (EVOO), a key component of the Mediterranean diet, has attracted research interest because olive-derived phenolics demonstrate potential anticancer activity in experimental models. This review summarizes evidence concerning whole EVOO, phenolic-enriched EVOO, olive phenolic extracts, and the isolated compounds hydroxytyrosol, oleuropein, oleocanthal, and oleacein. Methods: A structured narrative search of PubMed, Web of Science, ScienceDirect, and Google Scholar was conducted for literature published between 2015 and 2025. Evidence was reviewed for breast, prostate, colorectal, pancreatic, bone, oral, liver, gastric, hematological, and brain cancers. Comparatively limited evidence concerning cervical, endometrial, ovarian, melanoma, non-melanoma skin, and thyroid cancers was summarized separately. Results: The molecular evidence was derived primarily from cell culture and animal studies using isolated phenolics and concentrated extracts. Preclinical studies indicate that EVOO phenolics may demonstrate anticancer activity through multiple mechanisms, including antioxidant activity, anti-inflammatory effects, cell cycle arrest, induction of apoptosis, inhibition of metastasis, anti-angiogenic activity, and modulation of key signaling pathways, such as PI3K/AKT/mTOR, MAPK/ERK, NF-κB, JAK/STAT, Wnt/β-catenin, p53, and epithelial–mesenchymal transition-related pathways. Most molecular and pathway-level evidence was obtained using isolated phenolic compounds in cell culture or animal models, whereas evidence directly examining whole EVOO consumption was largely observational and substantially more limited. Experimental studies also reported that oleocanthal induced lysosomal membrane permeabilization, whereas hydroxytyrosol and oleuropein promoted mitochondria-mediated apoptosis. Furthermore, preclinical combination studies suggested enhanced tumor-cell sensitivity to selected chemotherapeutic, targeted, and immunotherapeutic agents. However, these effects have not been established in patients. Human evidence remains limited mainly to observational dietary associations and small exploratory interventions, with no conclusive demonstration of cancer prevention or therapeutic efficacy. Conclusions: Isolated EVOO-derived phenolic compounds demonstrated promising anticancer mechanisms in preclinical models. However, these results should not be directly extrapolated to dietary EVOO because experimentally administered doses, bioavailability, metabolism, and food-matrix interactions differ substantially from human dietary exposure. Therefore, well-designed studies using chemically characterized EVOO, pharmacokinetic investigations, and controlled human trials are required before dietary or clinical recommendations can be made.

Nutrients doi: 10.3390/nu18152415

Authors: Yejin Seo Soyoung Jung Hae Jin Kang Hee-Sook Lim Ji Youn Hong Jean Kyung Paik Dayeon Shin Yujung Lee Seung Wan Kang Yoo Kyoung Park

Objectives: The aim of this study was to evaluate whether dietary intake-guided precision nutrition interventions, derived from AI-driven food intake monitoring, improve cognitive function and electroencephalographic (EEG) biomarkers in older adults receiving long-term care. Methods: A total of 108 adults aged ≥50 years were recruited from five long-term care facilities. The study included 4 weeks of AI-driven dietary data collection, 2 weeks of data analysis and participant grouping, and 4 weeks of targeted nutritional intervention. Dietary intake was assessed using an AI-based food scanner. Anthropometric measures, biochemical markers, nutritional and cognitive questionnaires, and EEG were evaluated at baseline and postintervention. Participants were classified into three groups based on nutrient intake: “severely inadequate,” “marginally inadequate,” and “adequate.” Tailored food-based interventions, including nut mixes, senior-friendly meat products, and oral nutritional supplements, were provided according to group classification. Results: Energy intake increased in all groups. Nutritional status and cognitive function improved primarily in the severely inadequate group, while favorable EEG changes were observed across all groups. Changes in dietary composition and lipid profiles were observed in the “adequate” group, whereas the “marginally inadequate” group showed no significant changes. Conclusions: AI-based monitoring and nutritional intervention may improve nutritional status, cognitive-related outcomes, and EEG biomarkers in older adults receiving long-term care, supporting the potential of precision nutrition approaches in this population. Clinical Trial Registration KCT0009558 (CRIS, Republic of Korea).

Nutrients doi: 10.3390/nu18152414

Authors: Xiaojing Wu Abdur Rahman Hairui Yu Muhammad Uzair Akhtar Chengyu Ma Jiayi Zhang Leyong Yu Lingyao Li Govindhrajan Sattanathan Shahid Sherzada Baobin Lu

Background/Objectives: Natural bioactive compounds are promising interventions for obesity-related metabolic dysfunction. Lutein, a xanthophyll carotenoid with antioxidant and anti-inflammatory properties, may improve metabolic health, but its effects on liver function and gut microbiota in high-fat diet (HFD)-induced obesity are not fully elucidated. This study evaluated the effects of lutein supplementation on hepatic function, oxidative status, lipid metabolism, and gut microbiota composition in HFD-fed mice. Methods: Male C57BL/6J mice (6 weeks old) were randomly assigned to four groups (n = 8/group): Ctrl (low-fat diet), model (HFD), low-dose lutein (50 mg/kg/day), and high-dose lutein (100 mg/kg/day). Results: Following a 70-day intervention, lutein supplementation, particularly at the higher dose, reduced the liver index, improved serum lipid profiles, liver injury markers, and hepatic antioxidant capacity by increasing superoxide dismutase, catalase, and glutathione levels while reducing malondialdehyde content, and alleviated hepatic histopathological alterations. Lutein supplementation was also linked to elevated gut microbial richness and shifts in the relative frequency of several bacterial taxa, including partial restoration of Bacteroidota and enrichment of Roseburia and Faecalibaculum. These findings demonstrate that lutein supplementation attenuated HFD-induced metabolic and hepatic alterations, accompanied by improved antioxidant status and modulation of gut microbiota. Conclusions: Overall, lutein alleviated hepatic steatosis, oxidative stress, and metabolic dysfunction, highlighting its potential as a dietary strategy for managing obesity-related liver functions and gut dysbiosis.

Nutrients doi: 10.3390/nu18152413

Authors: Jennifer M. Connolly Andrea M. McNeilly

Background: Nutrition knowledge (NK) may influence dietary behaviours and athlete health; however, limited research has examined the relationship between NK and risk of low energy availability (LEA) in female team sport athletes. Objective: This study aimed to assess NK and LEA risk in female Ladies Gaelic Football (LGF) players and to examine the relationship between these variables. Results: Female LGF players (n = 58) aged 18–35 years completed a 75-item online questionnaire comprising the Abridged Nutrition for Sport Knowledge Questionnaire (ANSKQ) and the Low Energy Availability in Females Questionnaire (LEAF-Q). Mean total ANSKQ score was 53.1 ± 7.6%, categorized as “average”, while the mean sport nutrition knowledge (SNK) score was 48.2 ± 8.5%, categorized as “poor”. Lower micronutrient knowledge scores were observed among younger players and those with lower educational attainment (p < 0.05), while players with prior nutrition education demonstrated greater supplement-related knowledge (p < 0.05). Overall, 56.9% of the participants were classified as being at risk of LEA according to LEAF-Q criteria. LEA risk differed according to playing level and nutrition education status (p < 0.05); however, no association between overall NK and LEA risk was identified. Players identified as being at risk of LEA also demonstrated greater menstrual dysfunction and injury-related absence. Conclusions: These findings indicate a high prevalence of LEA risk and suboptimal sport NK among female LGF players and suggest that NK alone may be insufficient to protect against LEA risk in female team sport athletes. Ongoing screening, nutrition education, and broader athlete support strategies are therefore warranted in this population.

Nutrients doi: 10.3390/nu18152412

Authors: Katsumi Iizuka

Background: Body mass index (BMI) changes across the life course, yet most studies rely on single time-point measures and focus primarily on obesity. Whether self-reported eating speed is associated with long-term weight-history groups, including persistent underweight, remains unclear. Methods: This retrospective cohort study used Japanese health checkup data from 564,198 participants. According to BMI history in their twenties, participants were classified into normal-weight, underweight-history, and obesity-history groups. The underweight-history and obesity-history groups were further stratified according to the proportion of BMI measurements obtained during the entire observation period that indicated the respective weight state (0–25%, 25–50%, 50–75%, and 75–100%). Repeated BMI measurements were analyzed using linear mixed-effects models to characterize longitudinal differences across weight-history groups. Associations of self-reported eating speed with these groups were examined using sex-stratified multivariable logistic regression models. Results: BMI differed clearly across weight-history groups in both sexes. Self-reported eating speed showed a dose-dependent and bidirectional association. In women, the odds of fast eating increased progressively with increasing obesity proportion, reaching an adjusted odds ratio (OR) of 1.47 (95% CI 1.40–1.53) in the 75–100% obesity group; in men, the corresponding OR was 2.40 (95% CI 2.35–2.45). Conversely, the odds of slow eating increased with increasing underweight proportion, reaching ORs of 1.89 (95% CI 1.82–1.96) in women and 2.45 (95% CI 2.35–2.56) in men in the 75–100% underweight group. In additional analyses, self-reported eating speed also showed persistence over follow-up: the mean proportion of follow-up responses matching the baseline self-reported eating-speed category was 72.33% (95% CI 71.25–73.42) in women and 79.90% (95% CI 79.55–80.25) in men in the 75–100% obesity group for fast eating, and 72.84% (95% CI 72.00–73.68) in women and 68.24% (95% CI 67.08–69.39) in men in the 75–100% underweight group for slow eating. Conclusions: Self-reported eating speed showed a consistent bidirectional association with long-term weight-history groups in both sexes and remained relatively persistent over follow-up. These findings suggest that self-reported eating speed may be a behavioral correlate of long-term weight-history groups.

Nutrients doi: 10.3390/nu18152411

Authors: Fusun Erten Ecem Kalemoglu Omer Kucuk Kazim Sahin

Urologic malignancies (UMs), including prostate cancer (PCa), bladder cancer (BCa), renal cell carcinoma (RCC), and testicular germ cell tumors (TGCT), are governed by interconnected molecular pathways that regulate proliferation, angiogenesis, metabolism, invasion, immune escape, and treatment resistance. Key pathways include PI3K/AKT/mTOR, VEGF/VEGFR, EGFR, FGFR, c-MET, androgen receptor signaling, DNA damage response, inflammatory transcriptional programs, and regulation of the tumor microenvironment. This structured expert review evaluates mechanistic, translational, epidemiological, and clinical evidence on food- and botanical-derived nutraceuticals that may influence cancer-related signaling, redox balance, inflammation, metabolic adaptation, and host–tumor interactions. Nutraceuticals are considered investigational adjunctive exposures rather than anticancer treatments or alternatives to standard care. Relevant literature was identified through a structured, non-systematic search of PubMed/MEDLINE, Scopus, Web of Science Core Collection, and Embase from database inception to 17 June 2026, supplemented by backward and forward citation searches. Eligible evidence comprised preclinical, observational, interventional, pharmacokinetic, formulation, safety, and drug–nutraceutical interaction studies. Evidence was evaluated by cancer type, compound class, molecular context, formulation, exposure, translational maturity, and safety, and was classified into five stages: prevention signal, mechanistic plausibility, bioavailability and exposure feasibility, exposure-linked biomarker activity, and clinical benefit. An exposure–species–compartment framework was used to assess whether parent compounds and relevant metabolites reached systemic, urinary, or target-tissue concentrations compatible with the proposed effects. Findings based solely on supraphysiological concentrations of unconjugated parent compounds were considered hypothesis-generating unless supported by human exposure or tissue-distribution data. Curcumin, green tea catechins, isoflavones, carotenoids, flavonols, stilbenes, and triterpenoids affect several cancer-related pathways, primarily in experimental models. Translation to clinical practice is constrained by inconsistent formulations, limited bioavailability, inadequate target-tissue exposure data, few biomarker-linked studies, and possible interactions with anticancer therapies. PCa and BCa provide the most suitable settings for exposure-verified mechanistic studies. In RCC, safety and treatment interactions should be prioritized, whereas in TGCTs, non-interference with curative cisplatin-based therapy must be demonstrated. Future studies should use chemically defined formulations, verify clinically relevant exposure, incorporate mechanism-matched biological-response endpoints, and confirm compatibility with established treatment. Current evidence does not support nutraceuticals as treatments for urologic malignancies.

Nutrients doi: 10.3390/nu18152410

Authors: Ioana Muller Julien Blaess Margherita Giannini Camille Daeffler Veronique Vincent Anne-Laure Charles Marianne Riou Irina Enache Emmanuel Andrès Anne Charloux Alain Meyer Benjamin Renaud-Picard Bernard Geny

Background: Sarcopenia and malnutrition may contribute to persistent functional vulnerability after lung transplantation, yet their prevalence using actual criteria, relationship and clinical correlates remain incompletely defined. Methods: Ninety-nine adult lung transplant recipients (Ltx) were included in the study during their routine follow-up. Sarcopenia was defined using EWGSOP2 criteria, integrating muscle strength, dual-energy X-ray absorptiometry-derived appendicular lean mass, and physical performance. Malnutrition was assessed using GLIM criteria before transplantation and at follow-up. Clinical, nutritional, biological, body-composition, and pulmonary-function variables were compared according to sarcopenia status. Results: Sarcopenia was identified in 17 recipients (17.2%), including 12 (12.1%) with severe sarcopenia. Malnutrition was frequent before transplantation and persisted at follow-up, affecting 52 of 98 recipients (53.1%) before transplantation and 23 of 99 recipients (23.2%) after transplantation. Sarcopenia was related to underlying diseases leading to transplantation (mainly COPD and ILD) and sarcopenic Ltx were older (66.1 ± 6.7 vs. 57.7 ± 12.6 years; p = 0.05), had greater smoking exposure (38.2 ± 25.6 vs. 22.2 ± 20.2 pack-years; p = 0.02) and prednisone dose (13.5 ± 8.1 vs. 8.9 ± 2.7 mg/day; p = 0.001). Despite a trend towards lower albuminemia (40.5 ± 4.7 vs. 42.1 ± 4.3 g/L; p = 0.07), malnutrition was not associated with sarcopenia status. Lung function improved substantially after transplantation, with mean FEV1 increasing from 25.7 ± 16.6% to 82.0 ± 25.4% predicted at assessment (p < 0.001); however, FEV1 at assessment did not differ considering sarcopenia status. Conclusions: In lung transplant recipients, EWGSOP2-defined sarcopenia was common and largely uncaptured by BMI, malnutrition status, routine biomarkers, adiposity indices, or spirometry recovery. Malnutrition was reduced by personalized nutritional support but persisted in many patients, supporting more systematic muscle-health and nutritional assessment to allow reduced post-transplant morbidity.

Nutrients doi: 10.3390/nu18152409

Authors: Lanshi Tian Shan Yang Peng Li Jinzi Yin Jia Zhou Zhongmei He

Food-derived zinc-chelating peptides (ZCPs) have emerged as promising nutritional carriers that enhance zinc bioavailability and exert diverse biological activities. Compared with conventional zinc supplements, peptide-mediated zinc delivery systems exhibit superior gastrointestinal stability, reduced mineral precipitation, and improved intestinal transport efficiency. The present study demonstrates that ZCPs regulate zinc homeostasis through multiple mechanisms, including coordination chemistry, transporter-mediated absorption, regulation of the epithelial barrier, and interactions with the intestinal microenvironment. Beyond facilitating zinc absorption, peptide–zinc complexes exhibit antioxidant, anti-inflammatory, immunomodulatory, metabolic regulatory, and gut-protective activities through the synergistic effects of coordinated zinc ions and peptide bioactivity. Advances in spectroscopic characterization, computational modeling, and systems nutrition approaches have further expanded current understanding of peptide–zinc coordination behavior and physiological functionality. Nevertheless, current studies remain limited by insufficient clinical validation and an incomplete understanding of intestinal transport kinetics and controlled zinc release mechanisms. Overall, food-derived ZCPs demonstrate considerable potential for precision nutrition interventions and the development of next-generation functional zinc delivery systems.

Nutrients doi: 10.3390/nu18152408

Authors: Amr Sayed Ghanem Battamir Ulambayar Róbert Bata Marianna Móré Renáta Jávorné Erdei Attila Csaba Nagy

Background: Oral diseases remain a major public health challenge globally and in Hungary, where untreated caries, periodontal disease, and edentulism are highly prevalent. Diet is a key modifiable determinant of oral health, yet the cumulative impact of multiple unfavorable nutritional behaviors on self-perceived oral health has not been assessed at the national level in Hungary, nor have population-attributable fraction (PAF) estimates been reported. Methods: This cross-sectional study analyzed data from 5146 adults in the 2019 Hungarian European Health Interview Survey. A six-component nutritional-risk score was constructed from self-reported dietary behaviors (fruit intake, vegetable intake, sugary soft drink consumption, sweets consumption, processed meat consumption, and water intake). Survey-weighted logistic regression estimated associations between nutritional-risk categories and poor self-perceived oral health, adjusting for sociodemographic, lifestyle, and health-related covariates. Counterfactual PAFs with 95% Monte Carlo uncertainty intervals (1000 bootstrap replications) were estimated for three nutritional-risk scenarios. Results: The weighted prevalence of poor self-perceived oral health was 19.2%. Compared with participants with 0–1 unfavorable nutritional factors, those with 3 factors (OR = 1.37; 95% CI: 1.09–1.73) and 4–6 factors (OR = 1.46; 95% CI: 1.15–1.85) had significantly higher odds of poor oral health. Low water intake was independently associated with poor oral health (OR = 1.38; 95% CI: 1.16–1.64). The main counterfactual PAF analysis estimated that 16.1% (Monte Carlo 95% UI: 5.93–26.48%) of poor oral health burden was attributable to unfavorable nutritional profiles. High nutritional risk was also associated with active caries, gum bleeding, and tooth loss. Conclusions: Cumulative nutritional risk is independently associated with poor self-perceived oral health in Hungarian adults. Integrating dietary improvements into oral health prevention strategies may substantially reduce the population-level burden of oral disease.

Nutrients doi: 10.3390/nu18152407

Authors: Sezai Arslan Esra Dişci

Background: Classical phenylketonuria (PKU) requires the lifelong dietary restriction of phenylalanine-containing foods. In this study, we aimed to evaluate the effects of a phenylalanine-restricted diet on carnitine, amino acid, vitamin, and mineral status in children with classical PKU. Methods: This case–control study included 30 children with classical PKU and 30 age- and sex-matched healthy controls. Dietary adherence was categorized as good, moderate, or poor according to blood phenylalanine concentrations during the preceding year. Dried blood spot amino acid and acylcarnitine profiles combined with serum micronutrient and hematological parameters were analyzed. Results: No significant differences were observed between the PKU and control groups regarding tyrosine, free carnitine (C0), acetyl carnitine (C2), valine, or methionine concentrations (p > 0.05). Arginine levels were significantly lower in the PKU group than in controls (40.14 ± 29.89 vs. 48.25 ± 16.08 µmol/L, p = 0.008). Vitamin B12, folate, 25-hydroxyvitamin D, and mean corpuscular volume were significantly higher in patients with PKU (all p < 0.05). Dietary adherence exhibited a strong negative correlation with phenylalanine concentrations (r = −0.86, p < 0.001), a moderate negative correlation with the phenylalanine-to-tyrosine ratio (r = −0.56, p = 0.001), and a moderate negative correlation with body mass index (r = −0.55, p = 0.002). Conclusions: Children with classical PKU receiving long-term dietary treatment maintained adequate carnitine and micronutrient status. Reduced arginine concentrations observed in treated children with classical PKU warrant further investigation, although their clinical significance remains uncertain.

Nutrients doi: 10.3390/nu18152406

Authors: Tak Kyu Oh In-Ae Song

Background/Objectives: Total parenteral nutrition (TPN) is essential for neonates unable to receive adequate enteral feeding, but its long-term metabolic effects remain uncertain. This study evaluated associations between neonatal TPN exposure, exposure duration, and later endocrinologic or metabolic disorders. Methods: This nationwide cohort included 2,424,716 infants born in South Korea between 2005 and 2010. TPN exposure was identified during the first 28 days of life. The primary outcome was the first occurrence of type 2 diabetes mellitus (T2DM), essential hypertension, dyslipidemia, or obesity during follow-up of up to 18 years. The primary analysis used inverse probability of treatment-weighted (IPTW) Cox models, whereas duration-based associations were evaluated using secondary exploratory multivariable Cox regression. Results: The final cohort included 2,303,567 infants, of whom 7656 received TPN. In the primary IPTW analysis, any neonatal TPN exposure was not associated with either the primary composite outcome (HR 1.01, 95% CI 0.94–1.09; p = 0.801) or T2DM (HR 1.12, 95% CI 0.93–1.35; p = 0.215). In secondary exploratory multivariable analyses, TPN exposure for ≥3 days was associated with T2DM (adjusted HR 2.14, 95% CI 1.34–3.41; p = 0.001), whereas exposure for 1–2 days was not. Conclusions: The primary IPTW analysis showed no significant association between any neonatal TPN exposure and the primary composite outcome or T2DM. The association observed for ≥3 days in secondary exploratory analyses should be regarded as hypothesis-generating.

Nutrients doi: 10.3390/nu18152405

Authors: Rute F. Vitor Vanda Lopes de Andrade João Reis Miguel Macário Igor Dias Maria Figueiredo Maria Rodrigues Laura Mendes Inês Ferrão Rafael Barros Paula Ruivo

Background/Objectives: School-based programmes may play an important role in promoting healthier and more sustainable dietary habits from early childhood. This study described and evaluated a community-based intervention aimed at promoting Mediterranean diet (MD) principles, improving food literacy, and raising awareness of sustainable food practices among primary school children in the Tagus Lezíria region, Portugal. Methods: The intervention was implemented in 23 schools across 11 municipalities and included two seasonal rounds of participatory educational activities focused on healthy eating, local and seasonal foods, sensory exploration, balanced meals, composting, food storage, sustainable food production, and food waste prevention. A total of 872 children participated in the intervention activities, and 370 provided paired baseline and follow-up KIDMED assessments. Results: The mean KIDMED score decreased significantly from 8.0 ± 2.2 at baseline to 7.5 ± 2.4 after the intervention. Overall, 31.6% of participants improved their score, 18.9% showed no change, and 49.5% showed a decrease. The proportion of children who did not skip breakfast increased from 79.8% to 88.6%, and avoidance of fast-food restaurants more than once weekly increased from 85.4% to 89.6%. Smaller favourable changes were observed for pastry, sweet, and fish consumption, and olive oil use, whereas fruit, vegetable, pulse, and nut consumption did not improve. Conclusions: The intervention produced heterogeneous outcomes. Although overall MD adherence decreased, almost one-third of participants improved individually, with favourable changes in breakfast and selection of less healthy behaviours. Longer programmes with stronger family involvement may be required to reinforce core MD foods and achieve broader, sustained improvements.

Nutrients doi: 10.3390/nu18152404

Authors: Sisa H. Martins Mamakase G. Sello Musawenkosi Ndlovu Marakiya T. Moetlediwa Samukelisiwe S. Madlala Joel Choshi Phiwayinkosi Dludla André P. Kengne Zandile J. Mchiza Sihle E. Mabhida

Background/Objectives: Anaemia is a critical public health challenge in Sub-Saharan Africa (SSA), particularly among adolescents. The objective was to estimate the pooled prevalence of anaemia among adolescents in SSA and synthesise evidence on its nutritional and contextual determinants. Methods: A systematic search of databases including PubMed, CINAHL and Web of Science was conducted for studies published from January 2000 to October 2025. The methodological approach was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled prevalence estimates were computed using random-effects models, and heterogeneity was assessed using the I2 statistic and Cochran’s Q test. Subgroup and meta-regression analyses were performed to explore sources of variation. Determinants were synthesised as pooled odds ratios with 95% confidence intervals. Publication bias was evaluated through funnel plot asymmetry and Egger’s regression test. Results: Forty-eight (n = 48) studies involving 76,596 adolescents met the inclusion criteria. The pooled prevalence of anaemia was 33% (95% CI: 0.28–0.39), with substantial heterogeneity across studies. Factors associated with higher odds of anaemia included low dietary diversity (OR 1.74, 95% CI: 1.10–2.74) and poor iron or micronutrient supplementation adherence or lack of supplementation (OR 1.94, 95% CI: 1.25–3.01). Infection-related exposures (OR 3.03, 95% CI: 1.99–4.61) and environmental determinants (OR 2.23, 95% CI: 1.41–3.55) were also significantly associated with anaemia. Socio-demographic factors associated with anaemia included menstrual factors among girls (OR 2.51, 95% CI: 1.58–3.99), household size (OR 3.32, 95% CI: 1.61–6.85), awareness (OR 1.71, 95% CI: 1.08–2.70), and age group (OR 2.37, 95% CI: 1.47–3.83). Conclusions: Anaemia among adolescents in SSA remains an important public health concern, although the pooled estimates should be interpreted cautiously because of substantial heterogeneity and methodological differences across studies. The findings suggest that adolescent anaemia is associated with multiple nutritional and contextual factors, but more consistent and context-specific research is needed to refine regional estimates and guide interventions.

Nutrients doi: 10.3390/nu18142403

Authors: Junior Carlone Paolo Sgrò Attilio Parisi Alessio Fasano

Recovery in elite athletes represents a critical determinant of performance and health outcomes. The gut microbiota has been proposed as a modulating factor for recovery through anti-inflammatory mechanisms, oxidative stress management, sleep regulation, and biosynthetic potential for essential micronutrients. This review examines the mechanisms linking gut microbiota composition and function to athletic recovery and critically evaluates the evidence supporting its application in sports medicine. Athletes appear to harbor a more enriched microbial biosynthetic potential, with substantially greater numbers of high-biological-impact synthases involved in the production of vitamins, amino acids, and bioactive metabolites. Short-chain fatty acids, particularly butyrate and propionate, have demonstrated anti-inflammatory effects in preclinical studies, with emerging evidence in humans. The gut–brain axis has been proposed to modulate recovery by regulating neurotransmitter production and controlling circadian rhythms. Sport-associated microbial signatures seem to reflect metabolic demands, with endurance athletes showing enrichment for Prevotella and Veillonella, while strength athletes tend to harbor higher levels of proteolytic bacteria. Probiotic interventions with multi-strain Lactobacillus and Bifidobacterium formulations have reported reductions in inflammatory markers, improvements in oxidative stress biomarkers, and enhanced sleep quality in small-scale randomized controlled trials involving athletic populations, and improvements in self-reported sleep quality in a controlled, non-randomized study in elite athletes. Optimizing gut microbiota composition and function offers a promising complementary strategy for enhancing recovery in elite athletes. Potential applications that require prospective validation include sport-specific probiotic interventions, nutritional strategies to enhance short-chain fatty acid production, and the integration of microbiota assessment with traditional recovery monitoring. Further research is needed to establish standardized protocols and identify predictive biomarkers of individual response to microbiota-targeted interventions.

Nutrients doi: 10.3390/nu18142402

Authors: Yefu Xin Tianzhizi Fu Ralf Weiskirchen Han Chen Mengyu Cheng Rui Zhu Hualin Wang

As obesity, diabetes and other diet-related metabolic disorders continue to rise, non-nutritive artificial sweeteners (NASs) are widely used as sugar substitutes in free-sugar reduction and weight-management strategies, but their effects on the gut microbiota, host metabolism and related health outcomes remain debated. To clarify this evidence landscape, this review synthesizes current knowledge on the effects of major NAS on the gut microbiota and host metabolic and health-related outcome. A bibliometric analysis was conducted to characterize the development, knowledge structure and thematic evolution of this research area. For the eight NAS exposure categories included in this review (saccharin, cyclamate, aspartame, acesulfame potassium, sucralose, neotame, neohesperidin dihydrochalcone and mixed NAS), we performed a compound-specific analysis integrating physicochemical characteristics, regulatory status, and research findings from in vitro, ex vivo, animal and human studies on gut microbiota alterations, host metabolic and health-related outcomes. These findings were further compared through four interpretive dimensions: exposure conditions, research model background, outcome assessment and interpretation of discordant results. Current research evidence does not support a class-wide conclusion that NAS are uniformly harmful or safe. To make research findings searchable, we developed the NAS-MAP knowledge graph, an interactive non-nutritive artificial sweetener–microbiota-associated phenotype knowledge graph. Overall, this review consolidates current knowledge, clarifies the sources of inconsistent findings, and provides a framework for more mechanistically informative studies, standardized evidence reporting, and more precise sweetener-, exposure- and population-specific dietary and public health guidance.

Nutrients doi: 10.3390/nu18142401

Authors: Laura Marqués-Martínez Carlota Rosa Pérez-Dallal Juan Ignacio Aura-Tormos Carla Borrell-García Paula Boo-Gordillo María Carmona-Santamaría Clara Guinot-Barona Esther García-Miralles

Background/Objectives: Front-of-pack labelling systems such as Nutri-Score are promoted as public health tools to guide consumers towards healthier food choices. However, their capacity to accurately signal sugar content in child-targeted foods—a key determinant of dental caries risk—remains poorly characterised. This study aimed to evaluate whether Nutri-Score category reliably reflects sugar content in pre-packaged foods marketed to children, and to discuss the implications for paediatric oral health. Methods: A cross-sectional observational study analysed the nutritional labels of 100 pre-packaged foods directed at the paediatric population, all displaying a Nutri-Score label, selected from three major supermarket chains in Valencia, Spain. Products were grouped into eight predefined food categories. Sugar content (g/100 g or 100 mL), Nutri-Score category (A–E), and ordinal position of sugar in the ingredients list were recorded. Global association between Nutri-Score grade and sugar content was evaluated using Spearman’s rank correlation coefficient; category-level analyses used the Kruskal–Wallis or Mann–Whitney U test as appropriate. Results: A moderate statistically significant positive correlation was found between Nutri-Score grade and sugar content across all 100 products (ρ = 0.515, p < 0.001). In the exploratory category-level analyses, suggestive differences were observed in biscuits (H = 8.72, p = 0.033), milks and milk drinks (H = 9.02, p = 0.029), and desserts (H = 8.31, p = 0.016); none of these p-values survived Bonferroni correction for multiple comparisons (adjusted α = 0.006). Notably, some products rated A and B contained high sugar levels: one A-rated breakfast cereal reached 22.4 g/100 g, and the highest B-rated product (a flavoured milk drink) contained 22.1 g/100 g. No significant association was detected in cereals, breads, dairy products, juices, or frozen foods. Conclusions: Nutri-Score demonstrated limited discriminatory ability to identify high-sugar child-targeted foods consistently across food categories. These findings support recommending that paediatric dental practitioners advise caregivers to evaluate sugar content and ingredients lists beyond front-of-pack grading. Further regulatory refinement of the algorithm to specifically weight added sugar exposure in child-targeted products may be warranted.

Nutrients doi: 10.3390/nu18142400

Authors: Irene Zapata-Martínez Marta Herrador-López Víctor Manuel Navas-López Lara Bossini-Castillo Teresa Nestares Rafael Martín-Masot

Objectives: Celiac disease (CD) is an immune-mediated disorder triggered by gluten ingestion. Although a gluten-free diet (GFD) is the only effective treatment, patients may still experience inflammation, nutritional imbalances, and reduced quality of life. Physical activity (PA) has demonstrated anti-inflammatory benefits; however, its role in CD management remains unclear. This systematic review aimed to synthesize evidence on the associations of PA and the outcomes of exercise interventions in individuals with CD, focusing on metabolic, nutritional, clinical, and functional outcomes. Methods: Following PRISMA guidelines, we included peer-reviewed observational and experimental studies assessing PA in individuals with CD across all age groups, without language or date restrictions. Searches were conducted in PubMed, Scopus, Web of Science, EMBASE, and SPORTDiscus. The risk of bias was evaluated using JBI and Cochrane RoB 2 tools. Results: Fourteen studies (17 publications) were included, the vast majority of which were cross-sectional, along with one quasi-experimental study and two randomized controlled trial cohorts reported across five publications. Data from these predominantly observational studies suggested possible, yet inconsistent, links between higher PA levels and better profiles in body composition, inflammatory and oxidative markers, quality of life, and psychological outcomes. Positive associations were also observed in some studies regarding gastrointestinal symptoms and adherence to the GFD. However, findings on metabolic markers and bone mineral density were inconsistent and linked to dietary factors. Conclusions: While PA represents a potential adjunct in the comprehensive management of CD, particularly in relation to functional and inflammatory outcomes. However, the current evidence remains highly preliminary, limited, and inconsistent, which restricts the strength of any definitive conclusions. Therefore, high-quality, longitudinal studies and well-designed clinical trials are needed to confirm its long-term benefits, especially in the pediatric population, and to establish specific recommendations.

Nutrients doi: 10.3390/nu18142398

Authors: Rosaria Meccariello Maria Giovanna Tafuri Stefania D’Angelo

Microplastics (MPs) are emerging environmental contaminants increasingly detected in foods, beverages, and food-contact materials, making dietary intake a relevant route of human exposure. In sports nutrition, this issue may be particularly important because athletes often have high food and fluid consumption, frequent use of packaged sports nutrition products, dietary supplements, bottled beverages, and sport-specific hydration strategies. This narrative review, supported by a structured literature search, examines dietary MP exposure and its potential relevance to gastrointestinal function, gut microbiota, oxidative stress, inflammation, mitochondrial activity, endocrine regulation, metabolism, recovery, adaptation, and performance-related outcomes in athletes. Current evidence suggests that MPs and nanoplastics may interact with biological systems through mechanisms involving intestinal barrier disruption, microbiota alterations, inflammatory activation, oxidative damage, mitochondrial perturbation, endocrine-disrupting chemicals, and metabolic dysregulation. However, most available data derive from in vitro studies, animal models, food contamination analyses, exposure-estimation studies, and indirect human biomonitoring evidence. Direct studies in athletic populations are currently lacking. Therefore, the possible implications of MP exposure on recovery, adaptation, and exercise performance should be interpreted as biologically plausible but unproven. From a practical perspective, evidence-informed strategies may include reducing avoidable plastic-related exposure while maintaining adequate hydration, energy availability, nutrient timing, supplement quality, and dietary patterns that support antioxidant defenses, inflammatory balance, gut health, and physiological resilience. Future research should prioritize standardized exposure assessment, validated biomarkers, human biomonitoring, and sport-specific studies evaluating MP exposure in relation to physiological and performance-related outcomes.

Nutrients doi: 10.3390/nu18142399

Authors: Rita Nocerino Giuseppina Rosolia Teresa Rea Silvio Simeone Caterina Mercuri Alessandra Agizza Serena Coppola Roberto Berni Canani Laura Carucci

Background: Children with food allergy (FA) may develop eating difficulties that extend beyond medically required allergen avoidance, including food neophobia, selective eating, and avoidant/restrictive food intake disorder (ARFID)-related symptoms. This mixed-methods study aimed to assess ARFID symptoms, food neophobia, diet quality, and food-related psychological experiences in children with FA. Methods: Seventy children with confirmed FA were enrolled in an observational cross-sectional mixed-methods study conducted at a tertiary pediatric allergy center. Quantitative assessment included the Eating Disorders in Youth-Questionnaire (EDY-Q), the Italian Child Food Neophobia Scale (ICFNS), and the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). Qualitative data were collected from a purposive subsample of 26 children through semi-structured child-friendly interviews and drawing-based elicitation activities and were analyzed using inductive thematic analysis. Results: A positive EDY-Q screening result for ARFID-related symptoms was observed in 3 children (4.3%). Selective Eating showed the highest median EDY-Q domain score (median 1.50, IQR 0.67–4.00), followed by Food Avoidance Emotional Disorder (median 1.00, IQR 0.00–2.00) and Functional Dysphagia (median 0.00, IQR 0.00–2.00). Moderate food neophobia was observed in 45 children (64.3%), while 24 children (34.3%) were classified within the high food-neophobia category. KIDMED score was negatively correlated with EDY-Q total score (Spearman’s ρ = −0.302; p = 0.011), Selective Eating (ρ = −0.356; p = 0.002), and Functional Dysphagia (ρ = −0.238; p = 0.048). In an exploratory hierarchical regression, Selective Eating remained inversely associated with KIDMED after adjustment for demographic and FA-related covariates (β = −0.386; p = 0.002); however, the overall model did not reach statistical significance (p = 0.081), and the additional clinical covariates did not significantly improve model fit. Accordingly, the fully adjusted findings should be interpreted as exploratory. Qualitative analysis identified five themes: anticipatory fear of food and tasting, emotional memory of allergic reactions and generalization of risk, selective avoidance and food rigidity, reassurance-seeking and decision-making dependence, and ambivalent parental dynamics. Conclusions: Within this tertiary-care sample, positive EDY-Q screening results were uncommon, whereas broader food-related difficulties were identified. Pediatric FA assessment may benefit from attention to eating behavior, diet quality, and avoidance extending beyond confirmed allergens.

Nutrients doi: 10.3390/nu18142397

Authors: Israa M. Shatwan Noha M. Almoraie Najlaa M. Aljefree

Background/Objectives: The family health climate (FHC) questionnaire comprises two subscales: physical activity (FHC-PA) and nutrition (FHC-NU). We aimed to translate the FHC into Arabic, culturally adapt it, and evaluate its reliability and validity among adult Arabic speakers. Methods: The original scale was translated and back-translated, and face and content validity of the scale was reviewed by 10 nutritionists. The scale reliability was measured using Cronbach’s alpha (α). Exploratory factor analysis was conducted to establish construct validity. Results: The FHC demonstrated an acceptable level of content validity, with a scale content validity index/average of 0.93 and index/universal of 0.51. The scale exhibited high internal consistency (Cronbach’s alpha = 0.956, 0.928, and 0.939 for the total FHC, FHC-PA, and FHC-NU, respectively). Strong Kaiser–Meyer–Olkin values for FHC-PA and FHC-NU (0.946 and 0.947, respectively) and a significant Bartlett’s test of sphericity (p < 0.001) were observed. For the FHC-PA, a three-factor structure was identified, explaining 51.5% of the variance, whereas the FHC-NU exhibited a four-factor structure explaining 49.2% of the variance. Conclusions: The Arabic FHC scale is a valid and reliable tool for evaluating the family environment that influences health-related behaviors. It can serve as a valuable resource for developing family-oriented strategies for health promotion and disease prevention.

Nutrients doi: 10.3390/nu18142396

Authors: Pasquale Perrone Stefania D’Angelo

The biological effects of dietary polyphenols are increasingly understood to depend not only on their intake, but also on their bioavailability, host metabolism, and gut microbiota-mediated biotransformation. Because many native polyphenols are poorly absorbed in the upper gastrointestinal tract, a substantial fraction reaches the colon, where intestinal microorganisms convert them into lower-molecular-weight metabolites, including urolithins, phenyl-γ-valerolactones, phenolic acids, enterolignans, and equol. These metabolites may display distinct absorption profiles and biological activities compared with their parent compounds, although their physiological relevance differs according to metabolite class, exposure level, and supporting evidence. Interindividual differences in gut microbiota composition and function contribute to substantial variability in metabolite production, leading to the concept of microbial metabotypes, which classify individuals according to their capacity to generate specific microbial-derived metabolites. This narrative review critically examines gut microbiota-mediated polyphenol biotransformation, major microbial metabotypes, determinants of metabotype variability, and their potential relevance for precision nutrition. Particular attention is given to urolithin, equol, and enterolignan metabotypes while distinguishing relatively well-characterized models from emerging or insufficiently standardized metabolic phenotypes. We also discuss the level of evidence supporting biological effects related to mitochondrial function, endothelial homeostasis, metabolic regulation, inflammation, gut barrier integrity, and gut–brain communication, distinguishing human evidence from preclinical and mechanistic findings. Although metabotype-guided approaches may improve responder stratification in future nutritional studies, their clinical translation remains limited by heterogeneous challenge protocols, non-standardized analytical cut-offs, incomplete validation across populations, and insufficient long-term intervention data. Therefore, microbial metabotypes should currently be considered as promising functional biomarkers for research and stratified trial design rather than established tools for routine personalized dietary prescription.

Nutrients doi: 10.3390/nu18142395

Authors: Diána Sárga Lajos Biró Dániel Sándor Veres Márta Veresné Bálint

Background: Assessing overall diet quality has become increasingly important in nutritional epidemiology. The Healthy Eating Index (HEI) is one of the most widely used measures of diet quality; however, comparable data on Hungarian children are scarce. The current study aimed to assess the diet quality of Hungarian children using the Healthy Eating Index and to examine demographic factors associated with diet quality. Methods: This cross-sectional study included 666 children aged 4–10 years. Dietary intake was measured using three-day dietary records, and sociodemographic factors were collected via parental questionnaires. Diet quality was assessed using the Healthy Eating Index-2020 (HEI-2020). For the statistical analysis, linear regression, random forest models and one-way ANOVA with Tukey’s post hoc test were used. Results: The mean HEI score was 48.2 (SD 8.02), indicating low diet quality. Settlement type was significantly associated with the HEI score (p = 0.009). The multiplicity-corrected p-values for pairwise comparisons showed that children living in towns had significantly lower HEI scores (44.9, SD 7.97) than those living in county capitals (3.9, 95% CI:0.8–7.0, p = 0.006) and villages (−3.6, 95% CI: −0.61–−6.6, p = 0.011), but not significantly lower than those living in the capital (3.09, 95% CI: −0.25–6.4, p = 0.08). These differences were primarily related to whole-fruit and whole-grain component scores. Sex, age, and maternal education were not significantly associated with HEI score. The random forest model showed weak predictive performance (RMSE = 7.66). Conclusions: Diet quality among Hungarian children was generally suboptimal. The examined sociodemographic characteristics accounted for only a small proportion of the variability in the HEI score. This highlights the importance of ongoing research to understand dietary patterns and to uncover additional social, environmental, and behavioral aspects of dietary habits across cultures. Furthermore, the results indicate that interventions should also consider local food environments.

Nutrients doi: 10.3390/nu18142393

Authors: Anna Fleischer

Dysgeusia is a clinically consequential, but still under-standardized, toxicity of cancer treatment. In the immunotherapy era, taste disturbances are increasingly relevant for patients receiving immune checkpoint inhibitors, chimeric antigen receptor (CAR) T-cell therapies and T-cell-redirecting bispecific antibodies, with G protein-coupled receptor family C group 5 member D (GPRC5D)-directed treatment in multiple myeloma representing a particularly instructive high-burden model. We performed a structured critical narrative review with evidence mapping. PubMed/MEDLINE was searched from database inception to June 2026, complemented by citation tracking in Google Scholar, ClinicalTrials.gov searches and guideline documents relevant to oncology nutrition, oral supportive care and cancer-related taste dysfunction. Search concepts covered cancer-related dysgeusia, immunotherapy-associated oral toxicity, GPRC5D/talquetamab-associated dysgeusia, oncology nutrition, oral–gut microbiome biology, natural taste modulators and miraculin-based interventions. Dysgeusia can reduce appetite, food enjoyment, dietary diversity and protein energy intake, thereby contributing to weight loss, malnutrition risk, distress, social withdrawal and, in severe cases, treatment modification or discontinuation. Available evidence is heterogeneous: general cancer-treatment-associated dysgeusia is supported by broader observational and interventional literature; immunotherapy-associated dysgeusia is less systematically characterized; and GPRC5D/talquetamab-associated dysgeusia represents the most clinically visible and target-specific immunotherapy-associated phenotype. Emerging pilot data suggest that dried miracle berry or miraculin-containing products may improve selected taste perception and nutritional parameters in cancer-related dysgeusia, but direct evidence in immunotherapy-associated dysgeusia is not yet established. We, therefore, propose a claim-disciplined precision supportive-care framework integrating systematic taste phenotyping, early nutritional risk assessment, oral health evaluation, microbiome-aware but hypothesis-generating endpoints, individualized flavor and texture adaptation, cautious use of natural taste modulators in selected patients and iterative monitoring of patient-centered outcomes. Future trials should test whether dysgeusia-focused nutritional and taste-modulating supportive care interventions can improve intake, quality of life and treatment persistence without compromising immunotherapy safety or efficacy.

Nutrients doi: 10.3390/nu18142394

Authors: Anna Evelin Juhász Tímea Klaudia Kara Éva Csajbókné Csobod Réka Juhász

Background: Guar (Cyamopsis tetragonoloba), locust bean (Ceratonia siliqua), fenugreek (Trigonella foenum-graecum), and tara (Caesalpinia spinosa) are plant-derived materials that contain galactomannans as their major polysaccharide component. Galactomannans are soluble, highly viscous, and fermentable dietary fibers widely used in the food, pharmaceutical, and cosmetic industries because of their favorable technological properties. Methods: We performed our systematic search on 16 April 2026, in MEDLINE (via PubMed), Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL), without language restrictions. Eligible randomized controlled trials compared the effects of guar gum, locust bean gum, and fenugreek on glycemic parameters, lipid profile, and body weight-related outcomes in healthy adults or patients with metabolic disorders. Results: A total of 50 randomized controlled trials were included in the analysis. Of these, 27 investigated guar gum, 20 fenugreek (12 seed powder, 7 seed extract, 1 leaf extract), two mixed galactomannan preparations, and one locust bean gum intervention. Considerable heterogeneity was observed across studies regarding participant characteristics, intervention doses, and treatment duration. Nevertheless, fenugreek-derived preparations consistently improved glycemic outcomes. In contrast, guar gum demonstrated more consistent effects on lipid parameters. Effects on body weight and body mass index were less consistent across studies. Conclusions: Our findings suggest that the metabolic effects of galactomannans are source-dependent, with fenugreek-based interventions appearing to have greater potential for improving glycemic outcomes, while guar gum may be more effective in improving lipid parameters. Since these fibers can be easily consumed in the form of dietary supplements, it is worth considering their regular, daily intake. The protocol was prospectively registered in the PROSPERO database (CRD420261368159).

Nutrients doi: 10.3390/nu18142392

Authors: Pelin İsmailoğlu Zehra Topal Suzan Esra Deniz Adnan Yılmaz Sibel Mataracı Karakaş Nevnihal Akbaytürk Hatice Sevim Nalkıran İhsan Nalkıran Ünzile Yaman Şenay Çakıroğlu Levent Tümkaya

Background/Objectives: Cisplatin-induced testicular toxicity is commonly associated with oxidative stress; however, the early biological events preceding overt tissue injury remain incompletely characterized. Identifying interventions capable of preserving redox homeostasis during this subacute phase may improve our understanding of the initial mechanisms underlying testicular dysfunction. This study investigated whether methylsulfonylmethane (MSM), a naturally occurring organosulfur compound with antioxidant properties, modulates early oxidative responses in a subacute rat model of cisplatin-induced testicular toxicity. Methods: Thirty-two adult male Sprague–Dawley rats were randomly assigned to Control, Cisplatin (CIS), MSM, and CIS + MSM groups (n = 8/group). MSM (500 mg/kg/day, intraperitoneally) was administered for 10 consecutive days, while a single dose of cisplatin (7 mg/kg, intraperitoneally) was given on day 7. Oxidative stress biomarkers, antioxidant enzyme activities, intratesticular testosterone concentrations, inflammatory cytokines, GPX4 and HO-1 protein expression, histopathological alterations, and correlation analyses were evaluated. Results: Cisplatin exposure induced a marked oxidative imbalance, evidenced by increased malondialdehyde levels and reduced superoxide dismutase, catalase, glutathione peroxidase, and intratesticular testosterone concentrations (p < 0.05). MSM administration attenuated lipid peroxidation, restored antioxidant enzyme activities, and preserved intratesticular testosterone levels. Western blot analysis demonstrated a significant increase in GPX4 protein expression following cisplatin exposure, whereas MSM normalized GPX4 expression toward control values. In contrast, HO-1 expression and intratesticular IL-6 and TNF-α levels did not differ among the experimental groups. Histopathological evaluation revealed only mild structural alterations without corresponding differences in Johnsen score, indicating that biochemical and molecular disturbances preceded overt tissue degeneration. Correlation analysis further demonstrated close associations between antioxidant defense and preservation of endocrine function. Conclusions: Subacute cisplatin exposure primarily disrupted testicular redox homeostasis before prominent histopathological injury became evident. MSM was associated with attenuation of these early oxidative alterations accompanied by improved endogenous antioxidant enzyme activity, higher intratesticular testosterone concentrations, and normalization of GPX4 expression. These findings suggest that MSM may contribute to the maintenance of testicular redox homeostasis during the early phase of cisplatin-induced toxicity under the present experimental conditions.

Nutrients doi: 10.3390/nu18142391

Authors: Dimitrios Karayiannis Anna Elena Yatsulava Dimitra Katsigianni Georgios Poupouzas Charikleia S. Vrettou Vasileios Issaris Efthymia Botoula Marinella Tzanela Dimitra A. Vassiliadi Alice G. Vassiliou Ioanna Dimopoulou

Background/Objectives: Resting energy expenditure (REE) rises during critical illness, but its determinants and prognostic relevance remain incompletely characterized. Identifying a circulating signal that tracks REE could provide a bedside surrogate for metabolic demand where indirect calorimetry is unavailable. This prospective pilot study described longitudinal trajectories of indirect calorimetry-measured REE, Sequential Organ Failure Assessment (SOFA) score, serum cortisol and insulin-like growth factor-1 (IGF-1) over two weeks in the intensive care unit (ICU), examined whether the REE trajectory was attenuated by adjustment for these variables, and generated preliminary effect-size and variance estimates for mortality. Methods: This single-center pilot study enrolled 39 critically ill adults at Evangelismos General Hospital (Athens, Greece); sample size was pragmatic, not based on an a priori power calculation. REE (Q-NRG metabolic monitor), cortisol and IGF-1 were measured at admission and days 5–7, 10–11 and 13–14, alongside SOFA. Trajectories were modeled with linear mixed-effects models using all available repeated measures. Confounding was assessed by adding SOFA, cortisol and IGF-1 as covariates and evaluating attenuation of the time effect; no formal mediation analysis was performed. Causes of missing data were quantified and a completers-only sensitivity analysis was undertaken. Mortality was analyzed by Cox regression with ICU length of stay as the time variable. Estimation was emphasized throughout; point estimates and 95% confidence intervals (CIs) are reported in preference to significance testing. Results: Mean age was 54.6 ± 18.1 years; 69.2% were male; median admission SOFA was 6 (IQR 3–9). ICU and 28-day mortality were 20.5% (8/39) and 10.3% (4/39). REE/kg rose from 25.3 ± 3.7 to a peak of 27.2 ± 4.2 kcal/kg/day by days 10–11 (likelihood-ratio χ2 = 17.2, p = 0.0006). Attrition was driven predominantly by discharge alive (18 of 23 patients missing at days 13–14) rather than death (n = 2), and the trajectory was preserved in a completers-only sensitivity analysis (χ2 = 9.13, p = 0.028). Cortisol declined (21.1 to 13.4 μg/dL) and IGF-1 rose (80.0 to 105.4 ng/mL); SOFA was essentially unchanged. REE did not correlate with SOFA, cortisol or IGF-1 at any time-point, and the time effect was not attenuated by adjustment for them. Admission REE was not associated with ICU mortality (HR 1.00, 95% CI 1.00–1.00). Higher admission REE was associated with a longer ICU stay, and this persisted after adjustment for body mass index (p = 0.026) and fat-free mass (p = 0.001). Age (HR 1.04, 95% CI 1.00–1.09) and admission SOFA (HR 1.18, 95% CI 0.98–1.44) were the covariates most associated with ICU mortality. Conclusions: REE rose progressively over the first 10–11 days of critical illness. Its trajectory was not attenuated by adjustment for SOFA, cortisol or IGF-1, which is compatible with—but does not establish—independence from the adrenal and somatotropic markers measured here. Neither REE nor these hormones were associated with mortality; age and disease severity remained the dominant prognostic factors, supporting a larger confirmatory study.

Nutrients doi: 10.3390/nu18142390

Authors: Wenjiao Liang Lishiyuan Tang Jinghui Fan Rui Huang Jiaxuan Chen Lichun Qian

Background: Dihydromyricetin (DHM) is a food-derived flavonoid enriched in vine tea and has been reported to possess antioxidant and metabolism-regulating properties. This study was designed to characterize the multi-level nutritional responses to dietary DHM supplementation, with emphasis on hepatic redox–inflammatory status, jejunal barrier-related phenotypes, cecal microbiota remodeling, hepatic metabolomic alterations, and homocysteine (Hcy) metabolism-related markers in mice. Methods: Forty-eight healthy mice were assigned to a basal-diet control group or diets containing 50, 100, or 200 mg/kg DHM for 4 weeks. Growth performance, serum biochemistry, antioxidant parameters, hepatic antioxidant-related expression, hepatic inflammatory cytokines, jejunal morphology and tight junction proteins, cecal 16S rRNA profiles, hepatic metabolomics, and Hcy metabolism-related markers were assessed. Results: Dietary DHM improved serum and hepatic antioxidant status, as reflected by increased T-AOC and GSH-Px activity and decreased MDA concentrations (p < 0.05). DHM also modulated the hepatic cytokine profile, with decreased TNF-α concentration (p < 0.05) and increased IL-10 concentration (p < 0.01). DHM increased hepatic Nrf2 protein abundance, HO-1 protein abundance, and Gclc mRNA expression (p < 0.05). DHM also improved jejunal villus architecture, as indicated by increased villus height, decreased crypt depth, and an increased villus height-to-crypt depth ratio (p < 0.05). Jejunal Occludin and ZO-1 protein expression were increased in the DHM-treated groups (p < 0.05). Cecal microbiota analysis showed increased richness and diversity indices and altered microbial community structure. Hepatic metabolomics revealed changes involving vitamin B6 metabolism, purine metabolism, the pentose phosphate pathway, and α-linolenic acid metabolism. Serum Hcy levels decreased (p < 0.05), accompanied by increased hepatic BHMT and MTHFR protein abundance (p < 0.01). Conclusions: Dietary DHM supplementation improved hepatic redox status and supported a less pro-inflammatory cytokine profile in mice, accompanied by enhanced jejunal barrier-related phenotypes, cecal microbiota remodeling, hepatic metabolic alterations, and Hcy metabolism-related responses. These findings provide a multi-level nutritional evaluation of DHM and suggest its potential relevance for supporting intestinal barrier integrity and hepatic metabolic homeostasis under basal physiological conditions.

Nutrients doi: 10.3390/nu18142389

Authors: Wei-Yang Lu

γ-Aminobutyric acid (GABA) is an endogenous metabolite and signaling molecule that is widely distributed across plants, microorganisms, and mammalian tissues. Although classically viewed as the principal inhibitory neurotransmitter in the central nervous system, GABA also functions in peripheral organs, where it participates in receptor-mediated signaling, intermediary metabolism, epithelial barrier regulation, endocrine control, immune modulation, and host–microbiota communication. These features have renewed interest in oral GABA supplementation and in dietary or microbial strategies designed to increase luminal or circulating GABA availability. Despite increasing interest in oral GABA supplementation and microbiota-derived GABA, evidence remains fragmented across multiple disciplines and the translational relevance of peripheral GABA biology remains incompletely defined. This review considers GABA within a functional nutrient framework: not as an essential nutrient required to prevent deficiency, but as a nonessential bioactive metabolite whose exogenous availability may modulate physiological regulation under specific conditions. The literature was identified through structured PubMed searches of studies published from 2000 onward. This review summarizes current knowledge regarding exogenous sources of GABA, intestinal absorption, hepatic uptake, and metabolic fate, receptor-mediated and metabolite-mediated signaling mechanisms in peripheral tissues, and findings from experimental, preclinical, and clinical studies examining GABA supplementation in immune-, endocrine-, and metabolic-related contexts. The findings support GABA as a biologically active functional nutrient with potential roles in immune, endocrine, epithelial, hepatic, and metabolic regulation. While experimental studies consistently report beneficial effects on inflammatory and metabolic outcomes, human studies remain limited and have not yet established definitive clinical efficacy. Future studies should prioritize well-powered randomized controlled trials, dose–response analyses, long-term safety assessments, and biomarkers of tissue-specific GABA exposure and target engagement.

Nutrients doi: 10.3390/nu18142388

Authors: Matthew Carpenter James Brouner Owen Spendiff

Background/Objectives: Exogenous ketone supplementation has been proposed to enhance endurance performance by altering substrate metabolism and sparing muscle glycogen. Prolonged carbohydrate restriction may upregulate ketolytic capacity and could therefore modulate the response to exogenous ketone ingestion. This study investigated the impact of increasing circulating ketone bodies through exogenous ketone supplementation on endurance performance in athletes chronically adapted to a ketogenic diet. Methods: Participants (n = 9 recreationally active males, with ≥1 year of ketogenic adherence) visited the lab four times. The first visit determined their V.O2max. The second visit accustomed them to test procedures. In a counterbalanced design, visits three and four tested the consumption of a 60 g carbohydrate beverage (CHO), or a beverage comprising 60 g carbohydrate and 0.5 g/kg 1,3-butanediol (CHO + BD). This was followed by a 60 min set-intensity exercise bout, followed by a 16.1 km time trial. Results: βHB significantly increased in the CHO + BD group (rest: 0.72 ± 0.33 mmol/L; post-exercise: 1.69 ± 0.30 mmol/L) compared to CHO (rest: 0.80 ± 0.53; post-exercise: 0.55 ± 0.30) (p < 0.001). There was no significant difference in time trial performance between groups (1606 ± 138 s; 1620 ± 134 s; p > 0.05). During set intensity exercise, there was no significant main effect of supplementation on lactate concentration, substrate oxidation, oxygen consumption at a fixed workload, RPE or heart rate (p > 0.05). However, glucose was significantly lower at minutes 40 and 60 of set intensity exercise in CHO + BD compared to CHO. Conclusions: No significant effect of 1,3-butanediol ingestion on endurance performance was detected in this sample of nine chronically ketogenic male athletes. βHB significantly increased from resting levels; however, time trial performance did not differ between conditions. Given the small sample and limited statistical power, these preliminary findings indicate no detectable ergogenic effect under the present conditions rather than evidence of no effect, and larger studies are warranted.

Nutrients doi: 10.3390/nu18142385

Authors: Anna Anyżewska Roman Łakomy Tomasz Lepionka Andrzej Tomczak Jerzy Bertrandt

Background/Objectives: Police is an occupational group characterised by high and variable physical demands, shift work, and the need for sustained operational readiness. Despite the importance of maintaining good health in uniformed services, relatively little is known about dietary habits and nutritional status among police populations, particularly in Poland. Therefore, the aim of this study was to characterise dietary habits and nutritional status among Polish police officers participating in the National Health Programme. Methods: This cross-sectional study included 262 Polish police officers (216 men and 46 women) aged 19–64 years. A 61-item food frequency questionnaire (FFQ) was used to assess dietary behaviours and bioelectrical impedance analysis was used to assess body composition. Results: Suboptimal food consumption frequency patterns were observed for several food groups, including fruits, vegetables, whole grains, dairy products, nuts, and seeds. Female police officers reported more frequent consumption of fruits, vegetables, and grains, and less frequent consumption of processed meats, animal fats, sugar-sweetened beverages, energy drinks, beer, and spirits than male officers. Normal body weight according to BMI criteria was observed in 33% of participants, whereas only 16% of participants had normal fat mass index values. Excessive body weight was observed in 67% of participants, and excess fat in 82% of participants. Conclusions: The study provides a comprehensive characterisation of dietary habits and nutritional status among Polish police officers within the National Health Programme. These findings suggest the need for nutritional education, health promotion activities, and continued monitoring of dietary habits and nutritional status in this occupational group.

Nutrients doi: 10.3390/nu18142386

Authors: Javier Conde-Pipó Maria Leyre Lavilla-Lerma Alexander Achalandabaso-Ochoa Tomás Conde-Rienda Miguel Mariscal-Arcas Antonio Martínez-Amat

Background: Considerable inter-individual variability exists in exercise-induced adaptations among older adults. Although microbial ecosystems have been linked to muscle function and physical performance, the role of the oral microbiota in exercise responsiveness remains unclear. Objective: To explore whether baseline oral microbiota characteristics are associated with training-induced changes in relative handgrip strength (rHGS) in older adults. Methods: This preliminary exploratory longitudinal study included 18 community-dwelling older adults who completed a 16-week supervised exercise intervention. Oral microbiota composition was assessed at baseline using 16S rRNA gene sequencing. Participants were classified as responders when ΔrHGS was >0 and as non-responders when ΔrHGS was ≤0; this operational threshold did not account for measurement error or clinically meaningful change. Associations between baseline microbiota variables and ΔrHGS were examined using group comparisons, Spearman correlations, FDR correction, and exploratory linear regression models. Results: Responders showed higher baseline bacterial genus richness than non-responders at the nominal level (86.15 ± 8.90 vs. 71.60 ± 13.32; p = 0.023), although this difference did not remain significant after FDR correction (pFDR = 0.069). Baseline richness was positively associated with ΔrHGS (ρ = 0.578, p = 0.012, pFDR = 0.036) and remained associated with ΔrHGS in exploratory sensitivity models. Genus-level findings did not remain significant after FDR correction and were interpreted as exploratory candidate signals. Conclusions: In this preliminary cohort, greater baseline oral microbiota richness was associated with larger improvements in rHGS after exercise training. These hypothesis-generating findings require confirmation in larger studies with functional microbiome assessment before causal or predictive interpretations can be made.

Nutrients doi: 10.3390/nu18142387

Authors: Gianluca Di Cesare Chiara Monachesi Annalisa Carciofi Francesca Borgiani Anna Rita Incampo Simona Gatti Elena Lionetti

Background/Objective: Non-IgE-mediated food allergies (non-IgE-FAs) are increasingly recognized in infancy as causes of delayed gastrointestinal symptoms, nutritional compromise, and impaired growth. This retrospective study aimed to evaluate longitudinal growth outcomes in children with non-IgE-FAs managed with different dietary interventions and to explore phenotype-specific differences and clinical correlations. Methods: Children diagnosed with non-IgE-FAs at the Pediatric Clinic Unit of Salesi Hospital (Ancona, Italy) between July 2022 and June 2025 were included. Anthropometric, clinical, and laboratory data were collected at baseline (T0) and follow-up visits at 6, 12, and 18 months. Weight-, length-, and BMI-for-age z-scores were calculated using Growth Calculator 4.0. Longitudinal growth trends were assessed through individual linear regression slopes, and dietary intervention effects were evaluated with ANOVA models. Results: Thirty-seven children were included (57% male), 95% of whom were diagnosed with CMA. Slope analyses demonstrated significant positive trends for BMI z-scores (median 0.340, IQR −0.171 to 1.130; p = 0.013). BMI slope differed according to phenotype when comparing children with FPE and those with FPIAP (mean slope = 0.068 ± 0.795 vs. 0.782 ± 0.873, respectively; p = 0.048). No significant differences in BMI improvement were observed between children on an elimination diet, breastfed children whose mothers followed an elimination diet, and those on a free diet. Conclusion: Dietary management in children with non-IgE-FAs was associated with improved growth trajectories, particularly in BMI-for-age z-scores. Children with FPE showed a less favorable BMI trajectory than those with FPIAP. Although the choice of dietary strategy did not significantly affect growth outcomes in this cohort, individualized nutritional assessment and judicious use of elimination diets remain essential. Larger prospective studies are needed to refine phenotype-specific nutritional strategies and optimize long-term outcomes.

Nutrients doi: 10.3390/nu18142384

Authors: Ruiying Luo Qing Peng Su Wu Shuwen Liu Chan Wang

Background: Hyperlipidemia represents a pivotal risk factor for multiple cardiovascular and metabolic diseases, creating an urgent demand for safe, effective novel therapeutic interventions. Resveratrol (RES), a natural plant polyphenol, has exhibited great potential as a hypolipidemic agent for hyperlipidemia treatment. Methods: In this work, we established a high-fat diet (HFD)-induced hyperlipidemic mouse model to systematically investigate the lipid-regulating efficacy of RES. Results: Oral administration of RES significantly decreased serum levels of total cholesterol and low-density lipoprotein cholesterol, while markedly increasing high-density lipoprotein cholesterol concentrations. Histopathological analyses further demonstrated that RES alleviated HFD-induced hepatic and ileal injury. Moreover, RES significantly decreased the circulating levels of several bile acids (BAs), including taurodeoxycholic acid, taurolithocholic acid, lithocholic acid, and tauro-(α + β)-muricholic acid. RES also ameliorated HFD-induced gut microbial dysbiosis, as evidenced by a reduction in the Firmicutes/Bacteroidetes ratio, increased relative abundances of non_f_Muribaculaceae, Lactobacillus, Ileibacterium, and Bacteroides, and decreased abundances of Lachnospiraceae_NK4A136_group and unclassified f_Lachnospiraceae. Spearman correlation analysis revealed significant associations between gut microbial taxa and BA profiles, suggesting that coordinated regulation of the gut microbiota and BA metabolism contributes to the hypolipidemic effects of RES. Conclusions: Collectively, RES alleviates HFD-induced hyperlipidemia by remodeling gut microbiota composition and restoring bile acid metabolic homeostasis.

Nutrients doi: 10.3390/nu18142383

Authors: Saeid Chobdar Rahim Zehra Betül Ahi Beyza Çay Fatih Arıcan

Background/Objectives: Commercial collagen peptide products may differ in their structural characteristics and in vitro biological properties depending on manufacturing processes and hydrolysis conditions. However, comparative studies integrating simulated gastrointestinal digestion with structural, physicochemical, and cell-based analyses remain limited. This study comparatively evaluated commercially available bovine collagen peptide products marketed in Türkiye before and after simulated gastrointestinal digestion. Methods: Collagen peptide samples were characterized before and after simulated gastrointestinal digestion by determining hydroxyproline content, degree of hydrolysis (DH), molecular weight (MW) distribution, antioxidant activity, and fibroblast responses to investigate digestion-induced structural and biological changes. Results: Significant differences were observed among the evaluated products in hydroxyproline content, degree of hydrolysis, molecular weight distribution, antioxidant activity, and fibroblast responses. Simulated gastrointestinal digestion further hydrolyzed all collagen peptide samples, although the extent of structural modification varied among products. Antioxidant responses also differed following digestion, with some products maintaining relatively stable radical scavenging activity, whereas others exhibited increased or decreased antioxidant responses. Cell viability assays demonstrated that all collagen peptide samples were non-cytotoxic toward L929 fibroblasts under the experimental conditions. Conclusions: The findings indicate that simulated gastrointestinal digestion influences the structural characteristics and in vitro biological responses of commercial collagen peptide products to different extents. The observed differences among products suggest differential in vitro bioactivity associated with their structural characteristics and digestion behavior. Nevertheless, these findings are limited to in vitro observations and require confirmation through peptide characterization, bioavailability studies, animal models, and well-designed clinical investigations before conclusions regarding physiological efficacy or potential health benefits can be drawn.

Nutrients doi: 10.3390/nu18142382

Authors: Ji-Ye Han Do-Won Lim Osoung Kwon Yun Jung Lee Minji Choi Bori Lee Soohyang Noh Mansoo Cho Young-Mi Lee

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disorder requiring sustainable therapeutic alternatives. Cannabis sativa L. is a valuable industrial crop rich in bioactive secondary metabolites; its potential as a standardized functional ingredient for promoting skin health has not yet been fully investigated. This study aimed to evaluate the therapeutic effects of a chemically characterized C. sativa inflorescence ethanol extract (CSE) on AD. Methods: To evaluate the efficacy of CSE, phytochemical profiling was performed using UPLC, and its underlying molecular mechanisms were investigated in a DNCB-induced mouse model. Results: UPLC analysis was employed to establish the phytochemical profile, identifying 15 cannabinoids and quantifying 8 major components. CBDA was the most abundant component, with a content of 261.79 mg/g in the extract. In a DNCB-induced mouse model, CSE significantly reduced mast cell infiltration and serum IgE levels while downregulating Th2-associated cytokines. At the molecular level, CSE inhibited the activation of the MAPK, NLRP3 inflammasome, and JAK1/STAT6 signaling pathways. Crucially, CSE treatment substantially increased the expression of skin barrier proteins, such as filaggrin and involucrin, thereby enhancing skin hydration. Conclusions: These findings suggest CSE as a high-value functional ingredient capable of ameliorating AD by modulating multi-target immune responses. This study provides a robust scientific basis for utilizing standardized C. sativa inflorescence as a potent functional ingredient or a nutraceutical agent for the management of chronic skin inflammatory conditions.

Nutrients doi: 10.3390/nu18142381

Authors: Alicja Werblińska Piotr Jerzy Skrzypczak Magdalena Roszak Maciej Bryl Cezary Piwkowski Piotr Gabryel

Background/Objectives: Lung cancer remains the leading cause of cancer-related mortality worldwide, and surgical resection is the primary curative treatment for patients with early-stage non-small cell lung cancer (NSCLC). Patients undergoing lung cancer surgery are frequently affected by malnutrition, systemic inflammation, sarcopenia, and cancer-related cachexia, which may adversely affect postoperative recovery and clinical outcomes. Perioperative immunonutrition has been proposed as a strategy to support immune and metabolic responses associated with surgical stress. This narrative review summarizes current evidence regarding the role of perioperative immunonutrition in patients undergoing lung cancer surgery. Methods: This narrative review summarizes current evidence regarding perioperative immunonutrition in patients undergoing lung cancer surgery. Relevant studies evaluating perioperative immunonutrition, including formulations enriched with arginine, omega-3 fatty acids, glutamine, and nucleotides, were analyzed. Particular attention was given to clinical studies in thoracic surgical oncology, perioperative outcomes, inflammatory response, and current nutritional guideline recommendations. Results: Available evidence suggests that perioperative immunonutrition may improve nutritional and immunological status in patients undergoing lung cancer surgery. Clinical studies have reported reductions in postoperative complications, shorter chest drainage duration, improved nutritional indices, and decreased inflammatory markers in patients receiving immunonutritional support. Experimental and translational studies also indicate potential beneficial effects on immune cell function and inflammatory regulation. However, current thoracic-specific evidence remains limited because of small study populations, heterogeneity of nutritional protocols, and variability in study design. Conclusions: Perioperative immunonutrition appears to be a promising adjunct to comprehensive perioperative care in patients undergoing lung cancer surgery. Although preliminary evidence suggests potential benefits in postoperative recovery and nutritional optimization, its implementation should be individualized according to the patient’s nutritional status, disease stage, and overall treatment strategy. As immunonutrition modulates metabolic and immune pathways that may also influence tumor biology, nutritional interventions should be evidence-based, carefully monitored, and integrated within multidisciplinary perioperative care to maximize clinical benefits while minimizing potential unintended effects. Further large, well-designed randomized clinical trials are needed to establish standardized protocols and clarify the role of immunonutrition in thoracic surgical oncology.

Nutrients doi: 10.3390/nu18142380

Authors: Meryem Kahriman Nihan Çakır Biçer Murat Baş

Background: Although obesity is a recognized cardiometabolic risk determinant, debate persists over the most appropriate anthropometric technique. This study evaluated different anthropometric techniques for predicting cardiometabolic risk in Turkish adolescents and aimed to develop and temporally validate a machine learning–based prediction model, reported in accordance with the TRIPOD statement. Methods: Adolescents from the Türkiye Nutrition and Health Survey in 2010 (n = 1357) and 2017 (n = 561) were included. Anthropometric and biochemical parameters were assessed. BMI z-scores, waist-to-hip and waist-to-height ratios, triponderal mass index (TMI), visceral adiposity index (VAI), and lipid accumulation product (LAP) were calculated. Results: In ROC analysis, VAI showed the highest discrimination (AUC = 0.747, p < 0.001), followed by LAP (AUC = 0.670). In machine learning, XGBoost achieved the highest training discrimination (ROC–AUC = 0.879), whereas logistic regression was the most stable, with minimal overfitting (ΔAUC = 0.008). The logistic regression model was well calibrated (Brier score = 0.107; calibration slope 1.00 development, 1.03 external). External temporal validation showed comparable discrimination across models (AUC = 0.742–0.757), with logistic regression showing the greatest consistency. The model showed a high negative predictive value (NPV = 91.7%) and was therefore better suited to ruling out than ruling in cardiometabolic risk; positive findings warrant confirmatory testing (PPV = 35.4%). A simple logistic-based formula was derived. Conclusions: Machine learning approaches, together with the developed model and simplified formula, may be useful tools for estimating cardiometabolic risk in adolescents and could support a stepwise screening strategy, pending recalibration and prospective validation.

Nutrients doi: 10.3390/nu18142379

Authors: Seong-Uk Baek Jin-Ha Yoon

Background: With the continuous increase in the prevalence of single-person households, growing public health concerns have emerged regarding mental health. This study examined the associations among living alone, eating alone, and depressive symptoms. Methods: We analyzed a nationally representative sample of 23,066 adults from South Korea. Participants were asked whether they lived alone or with other household members and whether they usually ate breakfast, lunch, or dinner alone. Depressive symptoms were assessed using the Patient Health Questionnaire-9. An analysis was conducted to estimate the direct and indirect associations among living alone, eating breakfast, lunch, or dinner alone, and depressive symptoms, using odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among the participants, 12.7% lived alone and 87.3% lived with others. The prevalence of depressive symptoms was 10.6% among those living alone and 4.7% among those living with others. In the analysis, the OR (95% CI) for the total association between solitary eating and depressive symptoms was 1.94 (1.62, 2.35). The OR (95% CI) for the overall indirect association through eating alone was 1.36 (1.24–1.51). Conclusions: This study found an indirect association between living alone and depressive symptoms through solitary eating. Future longitudinal studies are required to establish the temporal ordering among living alone, eating alone, and depressive symptoms and to validate our findings.

Nutrients doi: 10.3390/nu18142377

Authors: Jakub Jurga Jarosław Kabaciński Anna Fryzowicz Michał Murawa

Background: Dietary nitrate may enhance skeletal muscle performance by increasing nitric oxide bioavailability. Although its benefits for endurance exercise are well documented, less is known about its effects on isokinetic strength and power performance. This study examined the effects of acute nitrate ingestion on isokinetic performance, neuromuscular activity, and metabolic responses in physically active men. Methods: Thirteen physically active young men (25.0 ± 5.2 years) participated in a randomized, double-blind, placebo-controlled crossover study. During separate experimental sessions, participants consumed either nitrate-rich beetroot juice containing 800 mg of nitrate or a low-nitrate placebo. Following a 2 h absorption period, they performed isokinetic knee extension–flexion tests at angular velocities of 60°/s, 180°/s, and 240°/s. Surface electromyography was recorded from the vastus medialis oblique and vastus lateralis oblique muscles, and blood lactate concentrations were measured before and after exercise. Results: Nitrate supplementation significantly improved peak torque, relative peak power, and selected torque angle variables at 60°/s and 180°/s compared with placebo (p < 0.05). In contrast, no significant differences were observed during the 240°/s fatigue protocol (p > 0.05). No significant differences were observed in electromyographic parameters or post-exercise blood lactate concentration. Similarly, post-exercise blood lactate concentrations were comparable between treatments (p > 0.05). Conclusions: Acute dietary nitrate supplementation may improve selected isokinetic performance variables during low- and moderate-velocity contractions, whereas no significant effects were observed during the 240°/s fatigue protocol. No changes were detected in electromyographic parameters or post-exercise blood lactate concentration. The physiological mechanisms underlying these findings remain to be established.

Nutrients doi: 10.3390/nu18142378

Authors: Allison T. Contillo Ock K. Chun Nancy R. Rodriguez

Background/Objectives. Protein needs increase with aging to support muscle health. These needs are further increased in older adults undergoing surgery, particularly in procedures limiting acute post-operative activity, such as total joint arthroplasty (TJA). However, tools to efficiently characterize dietary protein intake in clinical settings have remained undeveloped. This report describes the initial development and preliminary validation of a novel protein screener (Protein Assessment Screening Tool, PAST) for community-dwelling adults and a clinical population undergoing elective total joint arthroplasty (TJA). Methods. Participants (n = 48; 33 female, 15 male) were aged 40–70 years in the community-dwelling group (n = 22) and aged 50–70 years in the elective TJA group (n = 26). Both groups completed a 3-day food record and the PAST at two timepoints. Descriptive statistics were performed on demographic data. Differences between male and female participants and between groups were determined using independent t-tests or Mann–Whitney U tests as appropriate. The screener and 3-day food records were compared to determine sensitivity, specificity, and negative and positive predictive values (NPVs and PPVs), with a threshold of ≥1.2 g/kg/day representing adequate protein intake. Results. The PAST had relatively high sensitivity (78–87%) and PPVs (68–79%) but lower and more variable specificity (25–57%) and NPVs (33–57%); however, the 95% confidence intervals indicated variability. Conclusions. These preliminary findings demonstrate the potential clinical utility of the PAST. However, additional research is required to validate this tool prior to broad implementation in clinical practice.

Nutrients doi: 10.3390/nu18142376

Authors: Marco Rendine Samuele Venturi Mirko Marino Daniela Martini Patrizia Riso Alberto Battezzati Dorothy Klimis-Zacas Cristian Del Bo’

Background: Wild blueberries (WB), abundant in (poly)phenols such as anthocyanins and chlorogenic acids, have shown vascular benefits in several preclinical and epidemiological settings. However, evidence from human trials remains limited. This double-blind, randomized, placebo-controlled, crossover trial investigated the effects of the consumption of a WB drink on vascular reactivity and circulating adhesion molecules in healthy young adults. Methods: Participants received 300 mL of a WB drink (30 g of freeze-dried WB powder containing 740 mg total (poly)phenols, 460 mg total anthocyanins and 170 mg chlorogenic acid) or the same amount of a placebo (PL) drink. Blood pressure, heart rate, microvascular reactivity (i.e., reactive hyperemia index, RHI, lnRHI and FRHI) and arterial stiffness (i.e., augmentation index, AIx) were assessed at baseline and 2 h after consumption of the WB and PL drinks using Endo-PAT2000. In addition, plasma circulating adhesion molecules including vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and cluster of differentiation 15 (CD 15 or Lewis x) were analyzed using ELISA. Results: Overall, analysis of variance did not show a significant effect of treatment on the modulation of markers of vascular function and adhesion molecules but revealed an effect of time, with an increase in terms of microvascular reactivity (RHI, p < 0.01; lnRHI, p < 0.05; FRHI, p < 0.001) and augmentation index (AIx, p < 0.01), and a reduction in the circulating levels of VCAM-1 (p < 0.001) following the intake of both WB and PL drinks. Conclusions: In conclusion, the intake of a WB drink failed to affect vascular function in young healthy subjects. Larger-scale and longer-term intervention studies, particularly in individuals at increased cardiovascular risk and in those with vascular dysfunction, are warranted to further explore the role of WB in modulating vascular reactivity.

Nutrients doi: 10.3390/nu18142375

Authors: Martina Tosi Anne Daly Catherine Ashmore Ozlem Yilmaz Nas Alex Pinto Sharon Evans Anita MacDonald

Background/Objectives: In phenylketonuria (PKU), adherence to protein substitute (PS) is frequently suboptimal due to poor palatability, high volume, and sensory fatigue. A novel phenylalanine (Phe)-free L-amino acid microtablet PS has been developed to address these barriers. The microtablets incorporate a cellulose-based taste-masking coating and a sodium-alginate inner matrix intended to enable controlled amino acid release over approximately three hours. This study evaluated their short-term tolerability, acceptability, and adherence in children with PKU, with extended follow-up in a subgroup. Methods: A 7-day observational study was conducted in participants with PKU aged ≥3 years on a low-Phe diet in a single centre. The test product provided protein equivalent (PE) 54 g/100 g. Participants replaced at least one daily dose of their usual PS with the test product, providing 10 g or 20 g/day PE, with one child receiving 80 g/day. Daily gastrointestinal (GI) symptoms, PS intake, and adherence were recorded. Acceptability was assessed using structured ratings of palatability, ease of use, and overall preference. Longer-term tolerability and acceptability were then assessed in four adolescents who elected to continue the test product for an additional 28 days. Results: Ten participants completed the 7-day study. Adherence to the test product was high (80%), exceeding adherence to participants’ usual PS (70%). At baseline, nine participants reported none/mild GI symptoms, most commonly flatulence. One participant reported moderate/severe symptoms including constipation, flatulence, diarrhoea, bloating, burping, and abdominal discomfort. By day 7, all participants reported no or mild symptoms, with complete resolution in the child with moderate/severe baseline symptoms. Acceptability ratings were comparable between the test product and usual PS, and nine children (90%) reported no difficulty taking the test product. During the 28-day extension, adherence remained high, GI tolerance was maintained, and improved preference was noted, particularly due to reduced aftertaste. Conclusions: This novel slow-release PS microtablet was well tolerated, acceptable, and associated with high adherence. Its taste-masked, low-volume format offered practical advantages that may support sustained dietary adherence. Longer-term controlled studies are necessary to confirm these findings.

Nutrients doi: 10.3390/nu18142374

Authors: Agnieszka Lejk Karolina Myśliwiec Jędrzej Chrzanowski Maria Skalska Anna Stefanowicz-Bielska Malwina Musiał-Paździor Marta Herstowska Zuzanna Margas Kinga Drzewińska Ilona Iwaszko Krzysztof Szewczyk Barbara Pernak Julia Kropidłowska Jędrzej Antosiewicz Wojciech Fendler

Continuous glucose monitoring (CGM) interpretation in people without diabetes is expanding beyond general glycemic control toward more dynamic metrics, such as Rate of Change (RoC). In this fixed-sequence pilot study conducted in 30 healthy adult females, we evaluated associations between two structured 14-day lifestyle interventions and free-living conditions using standard CGM-derived glycemic variability metrics and a novel framework based on the rate-of-change (RoC) metrics and data clarity using an unblinded Abbott FreeStyle Libre 2 monitoring. The dietary intervention (calorie-tailored low-glycemic index regular meals) were associated with lower time spent in rising (+1 to +2 mg/dL/min) and falling (−2 to −1 mg/dL/min) RoC bins by 4.76 ± 1.87% (complete-case delta, p ≤ 0.0071), whereas the 14-day physical activity intervention showed smaller and less consistent RoC changes (0.41 ± 2.20, p ≥ 0.3549). These findings, despite some major study design limitations, suggest that RoC may be more responsive and sensitive to short-term dietary pattern modifications in normoglycemic women.

Nutrients doi: 10.3390/nu18142373

Authors: Alicja Nowak-Zaleska Olga Czerwińska-Ledwig Małgorzata Żychowska Katarzyna Meyza Dorota Łoboda Tomasz Pałka Agata Szlachetka Ewa Ziemann Tomasz Niewęgłowski Anna Kurkiewicz-Piotrowska

Background/Objectives: Rearrangement of the gut microbiota toward a symbiotic profile may be influenced by physical activity and diet in both healthy and obese individuals. This study aimed to characterize gut microbiota using next-generation sequencing (NGS) and to evaluate the effect of a 6-week Nordic Walking (NW) program combined with Time-Restricted Eating (TRE; 10 h eating window) in individuals with obesity. Methods: The study included healthy controls (C; n = 10; 64.7 ± 6.7 years) and individuals with obesity (A; n = 10; 60.0 ± 4.5 years). The intervention consisted of three moderate-intensity NW sessions per week, individually adapted to participants’ capacity. Gut microbiota was analyzed using nanopore 16S rRNA sequencing (V3–V9 regions). Results: Baseline microbial composition differed significantly between obese and control groups, with Bray–Curtis dissimilarity ranging from 49.98% (phylum) to 65.97% (species) (p ≤ 0.02). After intervention, within-group dissimilarity in the obese cohort (A vs. B) decreased to 25.24–51.86% but was not significant (p = 0.88–1.00). Post-intervention comparisons (B vs. C) still showed significant differences at higher taxonomic levels, including class (44.10%, p = 0.015), order (31.62%, p = 0.022), family (50.48%, p = 0.011), genus (58.09%, p = 0.005), and species (63.47%, p = 0.0003). Alpha diversity showed no significant differences at species and genus levels, but significant group effects were observed at higher ranks, including order (Shannon p = 0.01; Simpson p = 0.01), class (Simpson p = 0.02), and phylum (Shannon p = 0.02). Conclusions: The NW + TRE intervention was associated with partial normalization of gut microbiota structure and reduced microbial dissimilarity, suggesting a shift toward a more symbiotic profile; however, differences compared with controls persisted, indicating incomplete convergence after 6 weeks.

Nutrients doi: 10.3390/nu18142372

Authors: Teodor Ioan Trasca Ioana Mihaela Balan Nicoleta Mateoc-Sirb Aisha Simbiat Hussaini Annie Gaise Magomboane Sorin Mihai Cimpeanu

Background/Objectives: Food system assessments in Sub-Saharan Africa have predominantly focused on caloric availability, often overlooking the structural and nutritional quality of the food supply. This study examines what drives and constrains food system transformation in Sub-Saharan Africa under different development pathways, using long-term changes in caloric availability, adjusted protein density, the balance between animal and plant proteins, and the diversification of animal protein sources as the empirical basis for this assessment. Methods: The analysis is based on data from the Food and Agriculture Organization of the United Nations for the period 1961–2023, covering Nigeria, the Republic of the Congo, the Democratic Republic of the Congo, Kenya, South Africa and Ethiopia. A longitudinal approach was applied where data were available, complemented by a recent comparative analysis (2010–2023). Derived indicators include total protein supply, adjusted protein density, the share of animal and plant proteins and the Herfindahl–Hirschman index (HHI) to assess the diversification of animal protein sources. Results: Findings show that increases in caloric availability are not consistently associated with improvements in adjusted protein density or nutritional quality. Significant differences are observed across countries in protein supply levels, structural composition, and diversification patterns. Results reveal heterogeneous trajectories of food systems, from diversified to structurally constrained or highly concentrated systems. Conclusions: Beyond caloric availability, the structure and quality of the food supply are essential for assessing food system performance. Quantitative gains alone do not ensure improved nutritional or sustainable outcomes. The study highlights the importance of considering protein supply structure, diversification and nutritional efficiency in the context of SDG 2 (Zero Hunger) and broader food system transformation.

Nutrients doi: 10.3390/nu18142371

Authors: Esra Demir Yunus Can Ozalp Hasan Basri Ergun Burcu Uludag Oktay Olmuşçelik Gozde Ulfer Omar Alomari

Objective: We aimed to investigate the effects of a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet on symptom severity, quality of life, and fecal zonulin levels in patients with irritable bowel syndrome (IBS). Methods: Twenty-four patients with IBS were prospectively randomized to either a low-FODMAP diet (LFD) or a traditional diet (TD) for 4 weeks. IBS Symptom Severity Scale (IBS-SSS), IBS Quality of Life (IBS-QOL), and fecal zonulin levels were assessed at baseline and week 4 in both groups. In the LFD group, FODMAP-containing foods were gradually reintroduced after week 4, and all assessments were repeated at week 16. Changes in laboratory parameters, fecal zonulin levels, IBS-SSS, and IBS-QOL scores were evaluated. Results: Fecal zonulin levels did not differ significantly between groups at baseline or week 4, and no significant within-group changes were observed over time (all p > 0.05). IBS-SSS scores improved significantly at week 4 in both groups compared with the baseline (p < 0.05), with no significant difference in the magnitude of improvement between groups (p > 0.05). In the LFD group, IBS-SSS scores increased at week 16 compared with week 4 (p < 0.05). Similarly, IBS-QOL scores improved significantly at week 4 in both groups (p < 0.05), without significant between-group differences (p > 0.05). In the LFD group, IBS-QOL scores returned to baseline levels by week 16. Conclusions: Both the LFD and TD were associated with significant short-term improvements in IBS symptom severity and quality of life. However, the LFD did not demonstrate superiority over the TD. Furthermore, no statistically significant changes in fecal zonulin levels were observed in either group, although these findings should be interpreted cautiously. In the LFD group, some improvements observed at week 4 were attenuated following FODMAP reintroduction at week 16; however, these findings represent exploratory within-group observations and should not be interpreted as evidence of long-term treatment efficacy or sustained benefit following FODMAP reintroduction.

Nutrients doi: 10.3390/nu18142370

Authors: Jacob Michael Hands Kevin Blain Sahar Swidan Leigh A. Frame

Genomic testing for rare, highly penetrant cardiovascular pathogenic mutations is well established, but its scarcity limits broader clinical utility. As cardiogenomics matures, common single nucleotide polymorphisms (SNPs) associated with cardiovascular disease (CVD) risk are increasingly accessible to clinicians and patients through both clinician-ordered and direct-to-consumer (DTC) platforms. This narrative review synthesizes evidence for six common loci—APOA1, APOE, LIPC, LPL, ANGPTL3, and FADS1/2, here termed “candidate-actionable” in the limited sense that genotype-by-diet associations have been described, but the full chain of analytical validity, clinical validity, clinical utility, and evidence-supported management has not been demonstrated—that modulate lipid metabolism and CVD risk and that show genotype-by-diet interactions in observational and small interventional studies. We frame these loci as complementary to validated polygenic risk scores (PRSs), discuss two illustrative epistatic axes (APOE ε4 × FADS major T-allele; ANGPTL3 × LPL), summarize emerging epigenetic modulators of the same loci, and propose an integrated framework combining PRS, locus-level SNPs, and epigenetic state. All locus-specific dietary considerations are explicitly framed as hypothesis-generating pending validation in adequately powered, genotype-stratified prospective trials. A comparison of consumer and clinical testing platforms—updated to reflect recent ownership and regulatory changes—is provided.

Nutrients doi: 10.3390/nu18142368

Authors: Radu Dumitru Moleriu Teodora Piroș Lavinia Cristina Moleriu Călin Muntean Raluca Lupușoru Anca Mihaela Dicu Sebastian Ștefănigă Ruxandra-Cristina Marin

Background/Objectives: Convenience-oriented dietary behaviors acquired during the transition to university life may be associated with overweight and obesity status in young adults. This study aimed to characterize the dietary behaviors of Romanian university students and to evaluate their associations with overweight and obesity. Methods: This cross-sectional study included 921 university students aged 18–24 years (60.6% female; 67.8% urban residents). Self-reported dietary variables included fast-food consumption, sweets intake, fruit and vegetable intake, water intake, and replacement of meals with desserts. BMI categories were classified according to WHO criteria. Associations were evaluated using chi-square tests, Cramer’s V, and multivariable logistic regression adjusted for sex, age group, and residence environment. A five-item Dietary Risk Score (DRS; range 0–5) was constructed as an exploratory composite indicator of cumulative dietary behavioral burden. Cluster analysis was additionally performed to identify dietary behavioral phenotypes. Results: A total of 24.1% of participants were classified as overweight/obese, including 19.4% overweight and 4.7% obesity. Frequent replacement of meals with desserts (aOR 7.20; 95% CI 4.26–12.17) and fast-food consumption ≥3 times/week (aOR 1.98; 95% CI 1.26–3.10) were independently associated with overweight/obesity after adjustment for demographic variables. Male sex, older age, and urban residence were also independently associated with overweight/obesity. Distinct dietary behavioral phenotypes were identified, including a convenience-oriented cluster characterized by higher fast-food and sweets intake and the highest prevalence of overweight/obesity. The DRS demonstrated a dose–response relationship with overweight/obesity prevalence, increasing from 19.8% at DRS = 0 to 50.0% at DRS = 4, with an adjusted OR of 1.43 per one-point increase (95% CI 1.23–1.66; p < 0.001). Conclusions: Frequent meal replacement with desserts, higher fast-food consumption, and greater cumulative dietary behavioral burden were associated with overweight and obesity status among Romanian university students. The findings support the relevance of evaluating cumulative dietary behavioral patterns in young adults; however, the cross-sectional design precludes conclusions regarding causality or temporal directionality.

Nutrients doi: 10.3390/nu18142369

Authors: Guangyi Shen Dekun Cheng Jathya C. Karunathilaka Jieun Woo Donglu Li Jonica L. Wooton Patricia Jaynes Tingting Ju Weicang Wang

Background/Objectives: Watercress (Nasturtium officinale), a cruciferous vegetable rich in phenethyl isothiocyanate (PEITC) and bioactive phytochemicals, has demonstrated anti-inflammatory and cytoprotective activities in multiple disease models; however, its effects on colitis remain insufficiently characterized. In the present study, we investigated the effects of watercress extract supplementation in dextran sulfate sodium (DSS)-induced experimental colitis. Methods: Male C57BL/6 mice were fed either a standard AIN-93G diet or a diet supplemented with 0.5% (w/w) watercress extract for 4 weeks, followed by DSS administration to induce acute colitis. Colonic histopathological injury, immune responses, barrier integrity, and gut microbiota composition were evaluated. In addition, the activity of PEITC, a major bioactive constituent of watercress, was examined in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages in vitro. Results: Watercress extract attenuated DSS-induced colon shortening and reduced histopathological injury. The supplementation of watercress extract also decreased colonic immune cell accumulation, suppressed the expression of pro-inflammatory mediators, and preserved intestinal barrier integrity. The 16S rRNA gene amplicon sequencing further revealed that watercress extract reshaped gut microbial composition, including increased abundance of Monoglobus and Adlercreutzia, and reduced abundance of microbial taxa such as Enterococcus and Enterorhabdus. Moreover, PEITC suppressed LPS-induced inflammatory activation in RAW264.7 macrophages by reducing nitric oxide production, inhibiting p38 MAPK phosphorylation, and downregulating multiple inflammatory cytokines and chemokines. Conclusions: These findings demonstrate that watercress extract alleviates experimental colitis through attenuating mucosal inflammation, preserving intestinal barrier function, and modulating the gut microbiota, highlighting watercress as a promising dietary strategy for improving gut health and mitigating intestinal inflammation.

Nutrients doi: 10.3390/nu18142367

Authors: Andrea Nova Teresa Fazia Giovanni Di Caprio Alice Cinquepalmi Simone Perna Mariangela Rondanelli Luisa Bernardinelli

Background/Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder for which few modifiable risk factors are established. Vitamin C, due to its antioxidant and neuroprotective properties, has been hypothesized to reduce MS risk, but epidemiological evidence remains inconsistent. Methods: We conducted a prospective cohort study using UK Biobank data, including 486,908 adults aged 37–70 years free of neurological disease. Regular vitamin C supplementation was self-reported at recruitment. Incident MS cases were identified during a median follow-up of 13.5 years. Propensity score weighting was used to balance a wide range of demographic, lifestyle, and health-related confounders. Weighted Cox proportional hazards models were used to estimate hazard ratios (HRs). Effect modification by polygenic risk score (PRS) for MS was assessed, and multiple sensitivity analyses were performed. Results: During follow-up, 452 participants were diagnosed with MS. Vitamin C supplementation was reported by 8.8% of participants (missingness = 1.5%) and was associated with a lower risk of incident MS (HR = 0.51, [95%CI: 0.32; 0.82], p = 0.004). The estimate was consistent across multiple sensitivity analyses. The association varied according to genetic susceptibility, with significant nonlinear multiplicative interaction (p = 0.004) and additive interaction (p < 0.001). Specifically, significant associations were observed only among those with average or high MS-PRS. Conclusions: Vitamin C supplementation was associated with a lower risk of incident MS, with the association varying across levels of genetic susceptibility. Although residual confounding cannot be excluded, sensitivity analyses did not identify similar associations for overall supplement use or multivitamin use, providing some reassurance against a generalized healthy-user effect. Replication in independent cohorts is warranted.

Nutrients doi: 10.3390/nu18142366

Authors: Giuseppe Marano Elena Lucia Valle Giulio Carriero Caterina Brisi Gianandrea Traversi Osvaldo Mazza Gabriele Sani Marianna Mazza

Sleep disturbances are highly prevalent across psychiatric disorders and represent both a clinical feature and a potential transdiagnostic therapeutic target. Growing evidence suggests that the gut microbiota may contribute to sleep regulation through immune, metabolic, circadian, and neuroendocrine pathways. Prebiotics, defined as selectively utilized substrates that confer health benefits through modulation of host microorganisms, have received increasing attention as nutritional strategies capable of influencing the gut–brain axis. This narrative review summarizes preclinical and human evidence on prebiotic interventions in relation to sleep-related outcomes and psychiatric symptomatology, with particular attention to short-chain fatty acids, circadian regulation, inflammatory pathways, stress-related hypothalamic–pituitary–adrenal axis activity, and microbial metabolite signaling. Preclinical studies suggest that selected prebiotics may influence sleep architecture, stress resilience, neuroinflammation, and behavioral phenotypes, particularly under conditions of stress or sleep disruption, but translation to human populations remains preliminary. Available clinical studies are limited by small sample sizes, heterogeneous prebiotic formulations, variable doses and intervention durations, inconsistent microbiome methodologies, and frequent reliance on subjective sleep measures rather than polysomnography or actigraphy. Therefore, current evidence supports prebiotics as biologically plausible and generally well-tolerated adjunctive strategies, but not as established treatments for insomnia or psychiatric symptoms. Sleep may provide a clinically meaningful transdiagnostic framework for future nutritional psychiatry research, provided that adequately powered randomized controlled trials integrate objective sleep assessment, standardized microbiome and metabolomic profiling, and clinically relevant psychiatric outcomes.

Nutrients doi: 10.3390/nu18142365

Authors: Canan Altinsoy Evrim Kahramanoğlu Aksoy Mehmet Raşit Ayte Derya Dikmen

Background/Objectives: This exploratory comparative cross-sectional observational study investigated brain fog symptoms, cognitive function, sleep quality, quality of life, and selected serum biomarkers related to inflammation and neurocognitive function in newly diagnosed patients with celiac disease (ND-CeD), patients with CeD on a gluten-free diet (GFD-CeD), and controls. Methods: A total of 62 participants were included: ND-CeD patients (n = 18), GFD-CeD patients (n = 17), and healthy controls (n = 27) with no statistically significant differences in age or sex distribution across groups. Brain fog symptoms and severity, cognitive function, sleep quality, and quality of life were assessed using the Brain Fog Scale (BFS), Brain Fog Severity Score (BFSS), Montreal Cognitive Assessment (MoCA), Single-Item Sleep Quality Scale (SQS), and World Health Organization Quality of Life Questionnaire-Brief Form-TR (WHOQOL-BREF-TR), respectively. Serum BDNF, S100B, TLR4, IL-6, and nitric oxide (NO) levels were measured by ELISA. Results: ND-CeD patients had higher BFSs and BFSSs and lower MoCA, SQS, and WHOQOL-BREF-TR scores than healthy controls (p < 0.05). GFD-CeD patients showed numerically intermediate or more favorable scores than ND-CeD patients in several outcomes; however, most differences from controls were not statistically significant. Compared with ND-CeD patients, GFD-CeD patients had higher WHOQOL-BREF-TR General Health, Psychological Health, and Social Relationships scores (p < 0.05). In exploratory within-group analyses, after correction for multiple comparisons, higher BFS scores were associated with poorer psychological health and lower MoCA scores, and higher MoCA scores were associated with better psychological and physical health domains, particularly in the ND-CeD group. In the adjusted regression model, older age, income status, and newly diagnosed disease status were independently associated with MoCA scores. No statistically detectable between-group differences were observed in serum IL-6, NO, BDNF, S100B, or TLR4 levels. Conclusions: These preliminary findings suggest that brain fog symptoms, cognitive performance, sleep quality, and quality of life may deserve greater attention at diagnosis and during follow-up in celiac disease. Although GFD-CeD patients showed more favorable scores in some outcomes, these cross-sectional differences should not be interpreted as treatment-related improvement. Larger longitudinal studies with objective assessment of gluten-free diet adherence, disease activity, micronutrient status, sleep quality, and gut–brain axis-related biomarkers are needed to confirm these findings.